Cataract is the leading cause of reversible blindness worldwide,affecting millions,particularly the elderly.Over 65 million people suffer from significant visual impairment due to cataracts,with the burden being highe...Cataract is the leading cause of reversible blindness worldwide,affecting millions,particularly the elderly.Over 65 million people suffer from significant visual impairment due to cataracts,with the burden being highest in low-and middle-income countries where access to surgery is limited.Cataract surgery,one of the most commonly performed and cost-effective procedures,has evolved significantly.Traditional extracapsular cataract extraction(ECCE)has been largely replaced by phacoemulsifi cation,which uses ultrasonic energy through a small incision,reducing recovery time and complications.More recently,femtosecond laser-assisted cataract surgery(FLACS)has emerged,off ering enhanced precision but with ongoing evaluation of its cost-eff ectiveness.Intraocular lenses(IOLs)now allow for customized visual outcomes,addressing distance,near,and intermediate vision.Despite its safety,cataract surgery can still result in complications such as corneal edema and posterior capsular opacifi cation,requiring careful surgical management and patient education.展开更多
AIM:To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization(MR).METHODS:Summary-level data from large-scale genome-wide asso...AIM:To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization(MR).METHODS:Summary-level data from large-scale genome-wide association studies to examine the relationship between obesity and cataract were utilized.Obesity-related traits,including body mass index(BMI),waist-to-hip ratio(WHR),and waist circumference(WC).A two-sample MR approach was employed to assess the causal effect of obesity on cataract risk,while potential mediators were identified from suitable genome-wide association studies(GWAS)datasets.Additionally,a metabolic pathway analysis was conducted.RESULTS:An increase of 1 standard deviation(SD)in BMI,WHR,and WC was associated with a significantly higher risk of cataract(BMI:odds ratio(OR)1.0017,95%confidence interval(CI):1.0001-1.0032,P=0.0320;WHR:OR 1.0029,95%CI:1.0006-1.0051,P=0.0129;WC:OR 1.0020,95%CI:1.0001-1.0038,P=0.0390].These associations remained robust after adjusting for confounding factors in multivariable MR analysis.Furthermore,a two-step MR analysis identified eight potential metabolic mediators,with one mediator showing a significant causal role in the relationship between obesity and cataract.CONCLUSION:This work highlights the importance of addressing obesity as a modifiable risk factor for cataracts,particularly through metabolic pathways.展开更多
AIM:To introduce a novel technique for stabilizing the capsular bag in cataract surgery.METHODS:This retrospective observational case series included eyes with unstable capsular bag that underwent cataract surgery.A s...AIM:To introduce a novel technique for stabilizing the capsular bag in cataract surgery.METHODS:This retrospective observational case series included eyes with unstable capsular bag that underwent cataract surgery.A standard capsular tension ring(CTR)with 10-0 Prolene sutures was inserted into the capsular bag and fixated to the sulcus to stabilize the bag,enabling in-the-bag intraocular lens(IOL)implantation.Uncorrected distance visual acuity,corrected distance visual acuity(CDVA),and slit-lamp examination were performed preoperatively and at 1 and 6mo postoperatively.RESULTS:Of the 17 eyes from 15 patients(mean age 51.20±19.60y,male/female=11/6),8 had subluxation due to Marfan syndrome,3 due to trauma,5 due to zonular weakness,and 1 due to acute angle closure glaucoma.The preoperative mean CDVA(logMAR)was 0.56±0.67(mean spherical equivalent:−6.39±4.78 D).At 1mo postoperatively,the mean CDVA improved to 0.21±0.37(mean spherical equivalent:−0.35±1.07 D).At 6mo,the mean CDVA was 0.32±0.39,and the mean spherical equivalent was−0.34±0.99 D.All patients showed significant visual improvement at both postoperative visits(P<0.05),with stable IOLs in all cases.CONCLUSION:This technique offers a viable surgical option in complex cataract cases with zonulysis.展开更多
AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and ...AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and randomized controlled trial was conducted.Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group.In GM group,the range of peripheral anterior synechiae(PAS)was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation(PEI).PAS was separated only under a microscope.After separating the closed angle of 360°by this method,we used a surgical gonioscope to confirm the PAS range.If any remaining PAS was present,we would separate them with an iris repositor under the direct gonio-lens until angle of 360°was reopened.In GG group,PAS was separated under direct gonioscopy after PEI until angle of 360°was reopened.The range of residual PAS after GSLs was the primary outcome.Intraoperative complications(hyphema),intraocular pressure(IOP)and anti-glaucoma medication usage after operation were the secondary outcomes.RESULTS:Sixty eyes were included,each group comprising 30 eyes.The average age[GM group:66.3±6.8y(12 males),GG group:67.6±8.9y(7 males),P=0.550],the baseline IOP(GM group:29.6±11.5 mm Hg,GG group:32.4±12.2 mm Hg,P=0.366)and the average initial PAS extent(GM group:8.9±2.6h,GG group:9.4±2.5h,P=0.425)were similar in the two groups.In GM group,the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL.In GG group,the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL.The PAS after PEI was significantly reduced compared to the preoperative PAS in both groups(all P<0.001).The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference(P<0.001).Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy.The difference of hyphema grade between the two groups was statistically significant(P=0.019).CONCLUSION:PEI alone can not open 360°of angle completely.PEI+GSL significantly reduced PAS range.But for patients with CACG,GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.展开更多
Objective:To explore the intervention effect of comprehensive perioperative blood glucose management on patients with diabetes complicated with cataract surgery.Method:A total of 68 patients in our hospital from July ...Objective:To explore the intervention effect of comprehensive perioperative blood glucose management on patients with diabetes complicated with cataract surgery.Method:A total of 68 patients in our hospital from July 2024 to July 2025 were selected and randomly divided into the experimental group and the control group,with 34 cases in each group.The control group received routine blood glucose management,while the experimental group,on this basis,implemented individualized intervention 3 days before the operation,real-time regulation during the operation,dynamic management 7 days after the operation,and self-management training.Result:The blood glucose control in the experimental group was more stable 7 days after the operation.The total incidence of complications(2.9%)was significantly lower than that in the control group(38.2%),and the average hospital stay(5.1±1.0 days)was shorter than that in the control group(7.3±1.4 days).One week after the operation,the proportions of uncorrected visual acuity and visual acuity≥0.6(67.6%)were both better than those of the control group(p<0.001).Conclusion:The whole-course management of perioperative blood glucose can enhance the stability of blood glucose control,reduce the risk of complications,shorten the length of hospital stay,promote visual recovery,and has high clinical promotion value.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
Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before...Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.展开更多
Descemet’s membrane detachment(DMD)is defined as the detachment of Descemet’s membrane that occurs spontaneously or secondary to intraocular surgery.This review focuses on the characteristics and incidence of DMD fo...Descemet’s membrane detachment(DMD)is defined as the detachment of Descemet’s membrane that occurs spontaneously or secondary to intraocular surgery.This review focuses on the characteristics and incidence of DMD following phacoemulsification and glaucoma surgery,and aims to compare DMD cases after phacoemulsification(PCE)and different types of glaucoma surgery in terms of incidence,risk factors,clinical manifestations,diagnosis and management strategies.The reported incidence of DMD after PCE ranges from 0 to 5%,and the complication is less frequently observed following glaucoma surgery.Patients with DMD may be asymptomatic or present with severe visual impairment caused by corneal edema,which is associated with the size and location of the detachment.The management of DMD varies according to the primary surgical procedure(PCE or glaucoma surgery),as well as case-specific factors including visual acuity,corneal clarity,and the size and location of the detachment.Longitudinal observational studies are warranted to investigate the underlying cellular mechanisms of DMD.Retrospective studies can be conducted to clarify the incidence and identify all potential risk factors for DMD following glaucoma surgery.In addition,it is crucial to explore all possible risk factors to reduce and prevent this complication.展开更多
AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabe...AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabetic macular edema(DME)and visually significant cataract.METHODS:This nonrandomized,retrospective analysis included 54 eyes undergoing phacoemulsification with DEX-I(DEX-I group)and 47 eyes receiving anti-VEGF injections(anti-VEGF group).Best-corrected visual acuity(BCVA)and central macular thickness(CMT)were measured preoperatively and postoperatively at 1 and 3mo.RESULTS:The two groups had comparable baseline characteristics,with similar age(DEX-I:66.83±7.27y;anti-VEGF:66.81±6.79y)and gender distribution(51.9%vs 59.6%males).Both groups showed significant BCVA improvement at 1 and 3mo,with no significant intergroup differences.CMT reduction was significantly greater in the DEX-I group at 3mo(25.03%vs 14.07%;P=0.049),particularly in recalcitrant eyes(25.09%vs 11.10%;P=0.007).Postoperative intraocular pressure(IOP)>21 mm Hg was observed in 14.8%of DEX-I eyes and 4.25%of anti-VEGF eyes(P=0.08),normalizing by 3mo.DEX-I required no reinjection,while 29.79%of anti-VEGF eyes needed a fourth dose at 3mo.Complications were minimal,with one posterior capsular injury in the DEX-I group.CONCLUSION:Combined phacoemulsification with intravitreal DEX-I offers superior CMT reduction and comparable visual acuity improvement to anti-VEGF injections in DME,with fewer required treatments.It is an effective strategy for managing cataract with DME,offering benefits,especially for recalcitrant cases.Both therapies have favourable safety profiles,but further long-term studies are needed for clinical guidance.展开更多
AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing techn...AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.展开更多
Clinical investigations have suggested a potential link between cataracts and Alzheimer’s disease(AD).However,whether cataract has an impact on the progression of AD remains unclear.The objective of this research was...Clinical investigations have suggested a potential link between cataracts and Alzheimer’s disease(AD).However,whether cataract has an impact on the progression of AD remains unclear.The objective of this research was to determine the relationship between cataracts and AD.A cataract model was established in APP/PS1[mutant amyloid precursor protein(APP)and a mutant presenilin-1(PS1)gene]mice via lens puncture.Behavioural assays were used to evaluate cognitive function.Immunohistochemistry,immunofuorescence,and enzyme-linked immunosorbent assays(ELISA)were applied to detect AD-related pathology.Visual signals were markedly obstructed following surgery to induce cataracts,and these mice presented an increased cerebral amyloid-beta(Aβ)load,while no signifcant alterations in the levels of enzymes associated with Aβmetabolism were detected.In addition,compared with control mice,cataract model mice presented increased astrogliosis and microgliosis,along with elevated levels of proinfammatory factors.Moreover,cataract model mice presented more pronounced cognitive impairments than did control mice.Our study ofers experimental confrmation that cataract considerably contributes to the pathogenesis of AD,thereby emphasizing the importance of visual signals in maintaining cognitive well-being.展开更多
Objective: To investigate whether attaching a free lens anterior capsular disc to the corneal endothelial surface during femtosecond laser-assisted cataract surgery (FLACS) can effectively reduce postoperative corneal...Objective: To investigate whether attaching a free lens anterior capsular disc to the corneal endothelial surface during femtosecond laser-assisted cataract surgery (FLACS) can effectively reduce postoperative corneal endothelial cell loss. Methods: This prospective study included 97 cataract patients. Among them, 33 patients served as the experimental group, where a free lens anterior capsular disc was applied for corneal endothelial protection during FLACS. The remaining 64 patients formed the control group and underwent conventional FLACS. Changes in corneal endothelial cell density were compared between the two groups before surgery and one month postoperatively. Results: One month after surgery, corneal endothelial cell counts in both groups were lower than preoperative levels. However, the experimental group exhibited higher corneal endothelial cell counts than the control group, with a smaller reduction in cell counts (p < 0.05). The corneal endothelial cell loss rate in the experimental group was lower than that in the control group one month postoperatively (p < 0.05). At the one-month follow-up, there were no significant differences in LogMAR visual acuity or non-contact intraocular pressure between the two groups compared to preoperative values (p > 0.05). Additionally, no significant differences were observed between the experimental and control groups in terms of LogMAR visual acuity, non-contact intraocular pressure, improvements in LogMAR visual acuity, or changes in non-contact intraocular pressure (p > 0.05). Conclusion: Attaching a free lens anterior capsular disc to the corneal endothelial surface during FLACS can effectively reduce intraoperative corneal endothelial cell loss.展开更多
Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Desc...Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Descemet’s membrane(DM)and the posterior corneal stromal layer can be easily separated with minimal mechanical force.Several risk factors have been associated with the development of DMD including old age,improper intraoperative operation,corneal ectatic disorders,and endothelial disorders and so on[1-4].展开更多
As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL pow...As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.展开更多
Cataract surgery is still the most common surgery performed worldwide.It has evolved tremendously in terms of incision,from 12 mm to 1.8 mm,in terms of capsulotomy from envelope type to automated capsulorhexis,and fro...Cataract surgery is still the most common surgery performed worldwide.It has evolved tremendously in terms of incision,from 12 mm to 1.8 mm,in terms of capsulotomy from envelope type to automated capsulorhexis,and from rigid intraocular lens to foldable intraocular lenses.Manual small incision cataract surgery(MSICS)remains a valuable technique,particularly in rural and underserved areas,due to its cost-effectiveness and simplicity.Its low logistics and favorable outcomes are particularly useful for managing the cataract backlog in developing countries.This review highlights the history and evolution of MSICS,and the reasons for the advent and popularity of this technique,especially in developing countries.It reviews the various recent modifications of the technique,for example,from a superior incision approach to temporal incision to customized MSICS,2 mm MSICS,and astigmatism-correcting MSICS.It provides an overview of its applicability in complicated scenarios(viz.,small pupil,compromised cornea,pseudoexfoliation,subluxated cataract,etc.).It briefly reviews the clinical trials on MSICS and its comparison with phacoemulsification.Finally,the review emphasizes why every ophthalmic surgeon must know MSICS,its relevance in postgraduate teaching,and the role of MSICS simulators for the same.Overall,the review presents a comprehensive picture of the present status of this technique in the surgical armamentarium of ophthalmology.展开更多
The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presu...The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.展开更多
AIM:To analyze the characteristics and correlation of phacoemulsification parameters and anterior segment parameters in cataract patients with different blood glucose levels.METHODS:A total of 45 type 2 diabetic catar...AIM:To analyze the characteristics and correlation of phacoemulsification parameters and anterior segment parameters in cataract patients with different blood glucose levels.METHODS:A total of 45 type 2 diabetic cataract patients(45 eyes)treated in our hospital from March 2023 to April 2024 were stratified into two groups based on glycosylated hemoglobin(HbA1c)levels:group A:HbA1c<7%(n=18)and group B:7%≤HbA1c<8.5%(n=27);a total of 94 age-matched age-related cataract patients(94 eyes)were enrolled as the control group(group C).All underwent phacoemulsification with intraocular lens implantation.Anterior segment parameters,including corneal,lens and anterior chamber measurements,were recorded.Correlations between phacoemulsification parameters and anterior segment parameters were analyzed,and differences among groups were compared.RESULTS:In groups A and B,effective phacoemulsification time(EPT)negatively correlated with corneal endothelial cell density(CECD)(r=-0.315,P=0.035).Average phacoemulsification time(APT)positively correlated with the anterior corneal surface radius of curvature(Rm;r=0.402,P=0.006)and negatively correlated with the flat axis meridian curvature(K 1),steep axis meridian curvature(K 2),mean curvature(Km)of the anterior corneal surface,and lens density at 6 mm zones(PDZ3;all P<0.05).Average phacoemulsification energy(AVE)positively correlated with mean lens density(LD-mean),lens density at 2 mm zones(PDZ1),lens density at 4 mm zones(PDZ2),and PDZ3(all P<0.05),and negatively with pupil diameter(r=-0.385,P=0.009).In the group C,EPT showed a positive correlation with Pentacam nucleus staging(PNS)density grade,PDZ1,PDZ2,and PDZ3(all P<0.05).A positive correlation was observed between AVE and PNS classification(r=0.246,P=0.018).Conversely,AVE exhibited a negative correlation with CECD(r=-0.245,P=0.018).EPT in groups A and B was higher than that in the group C(P<0.05).Both EPT and APT in the group B were higher than those in the group A(P<0.05).In diabetic cataract patients,CECD,corneal density(CD),and posterior corneal surface height positively correlated with diabetes duration(P<0.05).Posterior corneal surface K 1 and Rm positively correlated with 7%≤HbA1c<8.5%(P<0.05).Total corneal astigmatism negatively correlated with HbA1c,2-hour post-breakfast blood glucose(2hPBG),and fasting insulin(FINS;P<0.05).CD and lens thickness(LT)positively correlated with FINS(P<0.05).CONCLUSION:Phacoemulsification parameters and blood glucose-related indices exhibited varying degrees of correlation with anterior segment parameters in cataract patients with different blood glucose levels.EPT in diabetic cataract patients was higher than that in age-related cataract patients,while EPT and APT in diabetic cataract patients with poor glycemic control were higher than those with good glycemic control.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
BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devas...BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devastating consequences on their health,social life,and academic performance and places a socio-economic burden on the child’s family and society as a whole.Globally,pediatric cataract is a significant contributor to ocular morbidity and blindness.Findings from this study will help quantify the visual benefits of pediatric cataract surgical interventions and identify opportunities for improving pediatric cataract services.AIM To evaluate the visual acuity outcomes of children after cataract surgery.METHODS The study employed a retrospective electronic review of pediatric cataract surgeries from January 2019 to July 2021 at the pediatric unit of the eye department at Komfo Anokye Teaching Hospital(KATH),Ghana.Patient clinical data including demographics,cataract presentation,pre-operative and post-operative visual acuity,surgical procedure,postoperative complications,interventions and refraction were collected and analyzed using the Statistical Package and Service Solution.Pearson'sχ2 test and regression statistics were used to summarize data at a significance of P<0.05.RESULTS 163 children(257 eyes)underwent cataract surgery at KATH.The overall mean age was 3.81±3.56 years.Congenital cataract was commonly observed(56.4 All children underwent keratometry and phacoemulsification procedures.A few children(9.8%)experienced postoperative complications while 90.8%did not require further intervention after the surgery.After the surgery 27.0%of the children had refraction and the majority were corrected for myopia and near addition(12.9%).An analysis of the association of postoperative visual acuity and the type of cataract was statistically significant(P value<0.05).There was a significant improvement in the visual outcomes following cataract surgery.CONCLUSION Timely pediatric cataract surgery improves postoperative visual outcomes.Creating awareness and implementing screening programs is important to ensure that the prevalence of childhood blindness is reduced to the barest minimum.展开更多
Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underly...Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underlying mechanisms remain poorly understood,limiting the development of precise and effective treatments.The advent of omics technologies has provided potent tools for unraveling the pathogenesis of pediatric cataract.By mapping expression profiles across various molecular levels,these omics approaches enhance our understanding of the disease’s etiological mechanisms,aid in the identification of novel biomarkers and key pathways,and offer researchers new insights for the innovative strategies in disease diagnosis and targeted therapies.In this review,we summarize the application of omics approaches in clinical and basic research on pediatric cataract over the past decade,encompassing genomics,transcriptomics,proteomics,and metabolomics.Furthermore,we discuss the current challenges and future prospects of omics analyses in pediatric cataract studies.展开更多
文摘Cataract is the leading cause of reversible blindness worldwide,affecting millions,particularly the elderly.Over 65 million people suffer from significant visual impairment due to cataracts,with the burden being highest in low-and middle-income countries where access to surgery is limited.Cataract surgery,one of the most commonly performed and cost-effective procedures,has evolved significantly.Traditional extracapsular cataract extraction(ECCE)has been largely replaced by phacoemulsifi cation,which uses ultrasonic energy through a small incision,reducing recovery time and complications.More recently,femtosecond laser-assisted cataract surgery(FLACS)has emerged,off ering enhanced precision but with ongoing evaluation of its cost-eff ectiveness.Intraocular lenses(IOLs)now allow for customized visual outcomes,addressing distance,near,and intermediate vision.Despite its safety,cataract surgery can still result in complications such as corneal edema and posterior capsular opacifi cation,requiring careful surgical management and patient education.
基金Supported by the National Natural Science Foundation of China(No.82501261)Medical Research Projects of the Jiangsu Provincial Health Commission(No.M2024041).
文摘AIM:To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization(MR).METHODS:Summary-level data from large-scale genome-wide association studies to examine the relationship between obesity and cataract were utilized.Obesity-related traits,including body mass index(BMI),waist-to-hip ratio(WHR),and waist circumference(WC).A two-sample MR approach was employed to assess the causal effect of obesity on cataract risk,while potential mediators were identified from suitable genome-wide association studies(GWAS)datasets.Additionally,a metabolic pathway analysis was conducted.RESULTS:An increase of 1 standard deviation(SD)in BMI,WHR,and WC was associated with a significantly higher risk of cataract(BMI:odds ratio(OR)1.0017,95%confidence interval(CI):1.0001-1.0032,P=0.0320;WHR:OR 1.0029,95%CI:1.0006-1.0051,P=0.0129;WC:OR 1.0020,95%CI:1.0001-1.0038,P=0.0390].These associations remained robust after adjusting for confounding factors in multivariable MR analysis.Furthermore,a two-step MR analysis identified eight potential metabolic mediators,with one mediator showing a significant causal role in the relationship between obesity and cataract.CONCLUSION:This work highlights the importance of addressing obesity as a modifiable risk factor for cataracts,particularly through metabolic pathways.
文摘AIM:To introduce a novel technique for stabilizing the capsular bag in cataract surgery.METHODS:This retrospective observational case series included eyes with unstable capsular bag that underwent cataract surgery.A standard capsular tension ring(CTR)with 10-0 Prolene sutures was inserted into the capsular bag and fixated to the sulcus to stabilize the bag,enabling in-the-bag intraocular lens(IOL)implantation.Uncorrected distance visual acuity,corrected distance visual acuity(CDVA),and slit-lamp examination were performed preoperatively and at 1 and 6mo postoperatively.RESULTS:Of the 17 eyes from 15 patients(mean age 51.20±19.60y,male/female=11/6),8 had subluxation due to Marfan syndrome,3 due to trauma,5 due to zonular weakness,and 1 due to acute angle closure glaucoma.The preoperative mean CDVA(logMAR)was 0.56±0.67(mean spherical equivalent:−6.39±4.78 D).At 1mo postoperatively,the mean CDVA improved to 0.21±0.37(mean spherical equivalent:−0.35±1.07 D).At 6mo,the mean CDVA was 0.32±0.39,and the mean spherical equivalent was−0.34±0.99 D.All patients showed significant visual improvement at both postoperative visits(P<0.05),with stable IOLs in all cases.CONCLUSION:This technique offers a viable surgical option in complex cataract cases with zonulysis.
基金Supported by the Program for Zhejiang Leading Talent of S&T Innovation(No.2021R52012)Key Research and Development Projects of Zhejiang Province(No.2022C03112).
文摘AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and randomized controlled trial was conducted.Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group.In GM group,the range of peripheral anterior synechiae(PAS)was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation(PEI).PAS was separated only under a microscope.After separating the closed angle of 360°by this method,we used a surgical gonioscope to confirm the PAS range.If any remaining PAS was present,we would separate them with an iris repositor under the direct gonio-lens until angle of 360°was reopened.In GG group,PAS was separated under direct gonioscopy after PEI until angle of 360°was reopened.The range of residual PAS after GSLs was the primary outcome.Intraoperative complications(hyphema),intraocular pressure(IOP)and anti-glaucoma medication usage after operation were the secondary outcomes.RESULTS:Sixty eyes were included,each group comprising 30 eyes.The average age[GM group:66.3±6.8y(12 males),GG group:67.6±8.9y(7 males),P=0.550],the baseline IOP(GM group:29.6±11.5 mm Hg,GG group:32.4±12.2 mm Hg,P=0.366)and the average initial PAS extent(GM group:8.9±2.6h,GG group:9.4±2.5h,P=0.425)were similar in the two groups.In GM group,the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL.In GG group,the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL.The PAS after PEI was significantly reduced compared to the preoperative PAS in both groups(all P<0.001).The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference(P<0.001).Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy.The difference of hyphema grade between the two groups was statistically significant(P=0.019).CONCLUSION:PEI alone can not open 360°of angle completely.PEI+GSL significantly reduced PAS range.But for patients with CACG,GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.
文摘Objective:To explore the intervention effect of comprehensive perioperative blood glucose management on patients with diabetes complicated with cataract surgery.Method:A total of 68 patients in our hospital from July 2024 to July 2025 were selected and randomly divided into the experimental group and the control group,with 34 cases in each group.The control group received routine blood glucose management,while the experimental group,on this basis,implemented individualized intervention 3 days before the operation,real-time regulation during the operation,dynamic management 7 days after the operation,and self-management training.Result:The blood glucose control in the experimental group was more stable 7 days after the operation.The total incidence of complications(2.9%)was significantly lower than that in the control group(38.2%),and the average hospital stay(5.1±1.0 days)was shorter than that in the control group(7.3±1.4 days).One week after the operation,the proportions of uncorrected visual acuity and visual acuity≥0.6(67.6%)were both better than those of the control group(p<0.001).Conclusion:The whole-course management of perioperative blood glucose can enhance the stability of blood glucose control,reduce the risk of complications,shorten the length of hospital stay,promote visual recovery,and has high clinical promotion value.
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.
基金Hospital Quality Management Research Fund Project of China Medical Quality Management Association(Project No.:YLZG202511)。
文摘Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.
文摘Descemet’s membrane detachment(DMD)is defined as the detachment of Descemet’s membrane that occurs spontaneously or secondary to intraocular surgery.This review focuses on the characteristics and incidence of DMD following phacoemulsification and glaucoma surgery,and aims to compare DMD cases after phacoemulsification(PCE)and different types of glaucoma surgery in terms of incidence,risk factors,clinical manifestations,diagnosis and management strategies.The reported incidence of DMD after PCE ranges from 0 to 5%,and the complication is less frequently observed following glaucoma surgery.Patients with DMD may be asymptomatic or present with severe visual impairment caused by corneal edema,which is associated with the size and location of the detachment.The management of DMD varies according to the primary surgical procedure(PCE or glaucoma surgery),as well as case-specific factors including visual acuity,corneal clarity,and the size and location of the detachment.Longitudinal observational studies are warranted to investigate the underlying cellular mechanisms of DMD.Retrospective studies can be conducted to clarify the incidence and identify all potential risk factors for DMD following glaucoma surgery.In addition,it is crucial to explore all possible risk factors to reduce and prevent this complication.
文摘AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabetic macular edema(DME)and visually significant cataract.METHODS:This nonrandomized,retrospective analysis included 54 eyes undergoing phacoemulsification with DEX-I(DEX-I group)and 47 eyes receiving anti-VEGF injections(anti-VEGF group).Best-corrected visual acuity(BCVA)and central macular thickness(CMT)were measured preoperatively and postoperatively at 1 and 3mo.RESULTS:The two groups had comparable baseline characteristics,with similar age(DEX-I:66.83±7.27y;anti-VEGF:66.81±6.79y)and gender distribution(51.9%vs 59.6%males).Both groups showed significant BCVA improvement at 1 and 3mo,with no significant intergroup differences.CMT reduction was significantly greater in the DEX-I group at 3mo(25.03%vs 14.07%;P=0.049),particularly in recalcitrant eyes(25.09%vs 11.10%;P=0.007).Postoperative intraocular pressure(IOP)>21 mm Hg was observed in 14.8%of DEX-I eyes and 4.25%of anti-VEGF eyes(P=0.08),normalizing by 3mo.DEX-I required no reinjection,while 29.79%of anti-VEGF eyes needed a fourth dose at 3mo.Complications were minimal,with one posterior capsular injury in the DEX-I group.CONCLUSION:Combined phacoemulsification with intravitreal DEX-I offers superior CMT reduction and comparable visual acuity improvement to anti-VEGF injections in DME,with fewer required treatments.It is an effective strategy for managing cataract with DME,offering benefits,especially for recalcitrant cases.Both therapies have favourable safety profiles,but further long-term studies are needed for clinical guidance.
文摘AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.
基金upported by the National Key Research and Development Program(2023YFC3605400)the Health Commission of Chongqing Municipality(2024GGXM003)the Natural Science Foundation of Chongqing(cstc2021jcyj-msxmX0335).
文摘Clinical investigations have suggested a potential link between cataracts and Alzheimer’s disease(AD).However,whether cataract has an impact on the progression of AD remains unclear.The objective of this research was to determine the relationship between cataracts and AD.A cataract model was established in APP/PS1[mutant amyloid precursor protein(APP)and a mutant presenilin-1(PS1)gene]mice via lens puncture.Behavioural assays were used to evaluate cognitive function.Immunohistochemistry,immunofuorescence,and enzyme-linked immunosorbent assays(ELISA)were applied to detect AD-related pathology.Visual signals were markedly obstructed following surgery to induce cataracts,and these mice presented an increased cerebral amyloid-beta(Aβ)load,while no signifcant alterations in the levels of enzymes associated with Aβmetabolism were detected.In addition,compared with control mice,cataract model mice presented increased astrogliosis and microgliosis,along with elevated levels of proinfammatory factors.Moreover,cataract model mice presented more pronounced cognitive impairments than did control mice.Our study ofers experimental confrmation that cataract considerably contributes to the pathogenesis of AD,thereby emphasizing the importance of visual signals in maintaining cognitive well-being.
基金Task Contract for the 2022 Dongguan Social Development Science and Technology Project,Project Name:Clinical Study on the Protection of Corneal Endothelium by the Anterior Capsular Flap in LenSx Femtosecond Laser-Assisted Cataract Surgery(Project No.:20221800901212)。
文摘Objective: To investigate whether attaching a free lens anterior capsular disc to the corneal endothelial surface during femtosecond laser-assisted cataract surgery (FLACS) can effectively reduce postoperative corneal endothelial cell loss. Methods: This prospective study included 97 cataract patients. Among them, 33 patients served as the experimental group, where a free lens anterior capsular disc was applied for corneal endothelial protection during FLACS. The remaining 64 patients formed the control group and underwent conventional FLACS. Changes in corneal endothelial cell density were compared between the two groups before surgery and one month postoperatively. Results: One month after surgery, corneal endothelial cell counts in both groups were lower than preoperative levels. However, the experimental group exhibited higher corneal endothelial cell counts than the control group, with a smaller reduction in cell counts (p < 0.05). The corneal endothelial cell loss rate in the experimental group was lower than that in the control group one month postoperatively (p < 0.05). At the one-month follow-up, there were no significant differences in LogMAR visual acuity or non-contact intraocular pressure between the two groups compared to preoperative values (p > 0.05). Additionally, no significant differences were observed between the experimental and control groups in terms of LogMAR visual acuity, non-contact intraocular pressure, improvements in LogMAR visual acuity, or changes in non-contact intraocular pressure (p > 0.05). Conclusion: Attaching a free lens anterior capsular disc to the corneal endothelial surface during FLACS can effectively reduce intraoperative corneal endothelial cell loss.
基金Supported by the Natural Science Foundation of Fujian Province(No.2024J011318No.2024J011321)Fuzhou Science and Technology Program(No.2023-S-005).
文摘Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Descemet’s membrane(DM)and the posterior corneal stromal layer can be easily separated with minimal mechanical force.Several risk factors have been associated with the development of DMD including old age,improper intraoperative operation,corneal ectatic disorders,and endothelial disorders and so on[1-4].
文摘As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.
文摘Cataract surgery is still the most common surgery performed worldwide.It has evolved tremendously in terms of incision,from 12 mm to 1.8 mm,in terms of capsulotomy from envelope type to automated capsulorhexis,and from rigid intraocular lens to foldable intraocular lenses.Manual small incision cataract surgery(MSICS)remains a valuable technique,particularly in rural and underserved areas,due to its cost-effectiveness and simplicity.Its low logistics and favorable outcomes are particularly useful for managing the cataract backlog in developing countries.This review highlights the history and evolution of MSICS,and the reasons for the advent and popularity of this technique,especially in developing countries.It reviews the various recent modifications of the technique,for example,from a superior incision approach to temporal incision to customized MSICS,2 mm MSICS,and astigmatism-correcting MSICS.It provides an overview of its applicability in complicated scenarios(viz.,small pupil,compromised cornea,pseudoexfoliation,subluxated cataract,etc.).It briefly reviews the clinical trials on MSICS and its comparison with phacoemulsification.Finally,the review emphasizes why every ophthalmic surgeon must know MSICS,its relevance in postgraduate teaching,and the role of MSICS simulators for the same.Overall,the review presents a comprehensive picture of the present status of this technique in the surgical armamentarium of ophthalmology.
基金Supported by the National Natural Science Foundation of China(No.82271063No.82471054)Central Guidance for Local Scientific and Technological Development Funding Projects(No.2024ZY01057).
文摘The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.
文摘AIM:To analyze the characteristics and correlation of phacoemulsification parameters and anterior segment parameters in cataract patients with different blood glucose levels.METHODS:A total of 45 type 2 diabetic cataract patients(45 eyes)treated in our hospital from March 2023 to April 2024 were stratified into two groups based on glycosylated hemoglobin(HbA1c)levels:group A:HbA1c<7%(n=18)and group B:7%≤HbA1c<8.5%(n=27);a total of 94 age-matched age-related cataract patients(94 eyes)were enrolled as the control group(group C).All underwent phacoemulsification with intraocular lens implantation.Anterior segment parameters,including corneal,lens and anterior chamber measurements,were recorded.Correlations between phacoemulsification parameters and anterior segment parameters were analyzed,and differences among groups were compared.RESULTS:In groups A and B,effective phacoemulsification time(EPT)negatively correlated with corneal endothelial cell density(CECD)(r=-0.315,P=0.035).Average phacoemulsification time(APT)positively correlated with the anterior corneal surface radius of curvature(Rm;r=0.402,P=0.006)and negatively correlated with the flat axis meridian curvature(K 1),steep axis meridian curvature(K 2),mean curvature(Km)of the anterior corneal surface,and lens density at 6 mm zones(PDZ3;all P<0.05).Average phacoemulsification energy(AVE)positively correlated with mean lens density(LD-mean),lens density at 2 mm zones(PDZ1),lens density at 4 mm zones(PDZ2),and PDZ3(all P<0.05),and negatively with pupil diameter(r=-0.385,P=0.009).In the group C,EPT showed a positive correlation with Pentacam nucleus staging(PNS)density grade,PDZ1,PDZ2,and PDZ3(all P<0.05).A positive correlation was observed between AVE and PNS classification(r=0.246,P=0.018).Conversely,AVE exhibited a negative correlation with CECD(r=-0.245,P=0.018).EPT in groups A and B was higher than that in the group C(P<0.05).Both EPT and APT in the group B were higher than those in the group A(P<0.05).In diabetic cataract patients,CECD,corneal density(CD),and posterior corneal surface height positively correlated with diabetes duration(P<0.05).Posterior corneal surface K 1 and Rm positively correlated with 7%≤HbA1c<8.5%(P<0.05).Total corneal astigmatism negatively correlated with HbA1c,2-hour post-breakfast blood glucose(2hPBG),and fasting insulin(FINS;P<0.05).CD and lens thickness(LT)positively correlated with FINS(P<0.05).CONCLUSION:Phacoemulsification parameters and blood glucose-related indices exhibited varying degrees of correlation with anterior segment parameters in cataract patients with different blood glucose levels.EPT in diabetic cataract patients was higher than that in age-related cataract patients,while EPT and APT in diabetic cataract patients with poor glycemic control were higher than those with good glycemic control.
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BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devastating consequences on their health,social life,and academic performance and places a socio-economic burden on the child’s family and society as a whole.Globally,pediatric cataract is a significant contributor to ocular morbidity and blindness.Findings from this study will help quantify the visual benefits of pediatric cataract surgical interventions and identify opportunities for improving pediatric cataract services.AIM To evaluate the visual acuity outcomes of children after cataract surgery.METHODS The study employed a retrospective electronic review of pediatric cataract surgeries from January 2019 to July 2021 at the pediatric unit of the eye department at Komfo Anokye Teaching Hospital(KATH),Ghana.Patient clinical data including demographics,cataract presentation,pre-operative and post-operative visual acuity,surgical procedure,postoperative complications,interventions and refraction were collected and analyzed using the Statistical Package and Service Solution.Pearson'sχ2 test and regression statistics were used to summarize data at a significance of P<0.05.RESULTS 163 children(257 eyes)underwent cataract surgery at KATH.The overall mean age was 3.81±3.56 years.Congenital cataract was commonly observed(56.4 All children underwent keratometry and phacoemulsification procedures.A few children(9.8%)experienced postoperative complications while 90.8%did not require further intervention after the surgery.After the surgery 27.0%of the children had refraction and the majority were corrected for myopia and near addition(12.9%).An analysis of the association of postoperative visual acuity and the type of cataract was statistically significant(P value<0.05).There was a significant improvement in the visual outcomes following cataract surgery.CONCLUSION Timely pediatric cataract surgery improves postoperative visual outcomes.Creating awareness and implementing screening programs is important to ensure that the prevalence of childhood blindness is reduced to the barest minimum.
基金supported by the General Program of Natural Science Foundation of Guangdong Province(2023A1515011102).
文摘Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underlying mechanisms remain poorly understood,limiting the development of precise and effective treatments.The advent of omics technologies has provided potent tools for unraveling the pathogenesis of pediatric cataract.By mapping expression profiles across various molecular levels,these omics approaches enhance our understanding of the disease’s etiological mechanisms,aid in the identification of novel biomarkers and key pathways,and offer researchers new insights for the innovative strategies in disease diagnosis and targeted therapies.In this review,we summarize the application of omics approaches in clinical and basic research on pediatric cataract over the past decade,encompassing genomics,transcriptomics,proteomics,and metabolomics.Furthermore,we discuss the current challenges and future prospects of omics analyses in pediatric cataract studies.
