Lens Thickness in Infants and Children with Cataracts.

Purpose: The purpose of this study was to determine the association between lens thickness and cataract in participants aged 0 to 5 years. Design: This was a prospective, multicenter, case-control study. Participants: We enrolled 118 participants (171 eyes) aged 0 to 5 years, mean age 14.6 ± 17.0 months, range 0 to 60 months. Methods: Lens thickness was measured on 342 ultrasound biomicroscopy (UBM) images. Main Outcome Measures: Lens thickness; feasibility of lens thickness measurement from UBM images. Results: The mean lens thickness among noncataracts was 3.60 ± 0.17 mm, compared with 3.16 ± 0.61 mm among cataracts (P < 0.0001). Lens thickness <3.5 mm was significantly associated with increased odds of cataract; adjusted odds ratio = 5.99 (95% confidence interval, 2.41-14.88; P < 0.0003) among participants age 0 to 7 months. Lens thickness was significantly associated with cataract laterality among participants age 0 to 7 months (P < 0.0001). Conclusions: Quantitative UBM can be used to evaluate lens thickness in infants and children with congenital cataracts. The lens in congenital cataract eyes was thinner than that of controls among infants. Abnormal lens thickness was significantly associated with cataract. Future longitudinal studies will examine the association between lens thickness and postcataract surgery outcomes. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Lens Regeneration: The Application of iSyTE and In Silico Approaches to Evaluate Gene Expression in Lens Organoids.

Several protocols have been established for the generation of lens organoids from embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs), and other cells with regenerative potential in humans or various animal models. It is important to examine how well the regenerated lens organoids reflect lens biology, in terms of its development, homeostasis, and aging. Toward this goal, the iSyTE database (integrated Systems Tool for Eye gene discovery; https://research.bioinformatics.udel.edu/iSyTE/ ), a bioinformatics resource tool that contains meta-analyzed gene expression data in wild-type lens across different embryonic, postnatal, and adult stages, can serve as a resource for comparative analysis. This article outlines the approaches toward effective use of iSyTE to gain insights into normal gene expression in the mouse lens, enriched expression in the lens, and differential gene expression in select mouse gene-perturbation cataract/lens defects models, which in turn can be used to evaluate expression of key lens-relevant genes in lens organoids by transcriptomics (e.g., RNA-sequencing (RNA-seq), microarrays, etc.) or other downstream methods (e.g., RT-qPCR, etc.).

Nuclei Isolation from Ocular Tissues of the Embryonic Chicken for Single-Nucleus Profiling.

The generation of quality data from a single-nucleus profiling experiment requires nuclei to be isolated from tissues in a gentle and efficient manner. Nuclei isolation must be carefully optimized across tissue types to preserve nuclear architecture, prevent nucleic acid degradation, and remove unwanted contaminants. Here, we present an optimized workflow for generating a single-nucleus suspension from ocular tissues of the embryonic chicken that is compatible with various downstream workflows. The described protocol enables the rapid isolation of a high yield of aggregate-free nuclei from the embryonic chicken eye without compromising nucleic acid integrity, and the nuclei suspension is compatible with single-nucleus RNA and ATAC sequencing. We detail several stopping points, either via cryopreservation or fixation, to enhance workflow adaptability. Further, we provide a guide through multiple QC points and demonstrate proof-of-principle using two commercially available kits. Finally, we demonstrate that existing in silico genotyping methods can be adopted to computationally derive biological replicates from a single pool of chicken nuclei, greatly reducing the cost of biological replication and allowing researchers to consider sex as a variable during analysis. Together, this tutorial represents a cost-effective, simple, and effective approach to single-nucleus profiling of embryonic chicken eye tissues and is likely to be easily modified to be compatible with similar tissue types.

Analysis of lens cloudiness during endoscopic submucosal dissection procedures: Effects of a novel lens cleaner.

Objectives: We aimed to identify independent factors for intraoperative endoscopic lens cloudiness during gastric and colorectal endoscopic submucosal dissections, investigate the effectiveness of Cleastay, an endoscope anti-fog solution, and examine factors associated with severe submucosal fat deposition. Methods: A total of 220 patients who underwent gastric or colorectal endoscopic submucosal dissections in two institutions between January 2022 and October 2023 were included. Significant factors related to cloudiness were determined using univariate and multivariate analyses. Patient background and tumor characteristics related to severe submucosal fat deposition were investigated, and the degree of intraoperative endoscopic lens cloudiness and outcomes were compared between the Cleash and Cleastay groups. Results: In the multivariate analysis, factors increasing lens cloudiness included long procedure time (odds ratio [OR], 17.51; 95% confidence interval [CI], 1.52-202.08), stomach (vs. colon; OR, 5.08; 95% CI, 1.99-12.96), and severe submucosal fat deposition (OR, 12.19; 95% CI, 5.02-29.60). Conversely, the use of Cleastay (vs. Cleash; OR, 0.066; 95% CI, 0.021-0.21) was identified as a factor reducing cloudiness. Location analysis revealed that severe submucosal fat deposition was more common in the upper stomach and right colon. Conclusions: It was suggested that Cleastay is more useful for endoscopic submucosal dissection of the upper stomach and right colon, where severe submucosal fat deposition is expected.

Unilateral acute cataract after facial aesthetic procedure: a case report

ABSTRACT Aging and face sagging have many causes, and various techniques are used for treatment, including noninvasive procedures, such as focused ultrasound, which uses the principle of collagen regeneration by coagulative necrosis of the dermis layers using radiofrequency, but this procedure has complications. We reported a case of a 54-year-old female patient who complained of poor visual acuity in her right eye three days after a focused ultrasound facial aesthetic procedure, with the best visual acuity of 20/60. Biomicroscopy of the right eye revealed an acute cataract with three points of fibrosis extending from the posterior to the anterior capsule. The patient underwent phacoemulsification surgery with visual rehabilitation and improved vision of 20/20. We hypothesized that the occurrence of acute cataract was related to the inappropriate use of focused ultrasound.

Night-time blood pressure dipping, but not 24-h blood pressure level, is linked to increased 24-h ocular volume slope

ABSTRACT Purpose: This study investigated the relationship between blood pressure and intraocular pressure in treatmentnaive, non-glaucoma patients with different blood pressure statuses, focusing on the 24-h ocular volume and nocturnal blood pressure decline. Methods: Treatment-naive, non-glaucoma patients undergoing hypertension evaluation were enrolled as study participants. Simultaneous 24-h ambulatory blood pressure measurement and 24-h ocular volume recording with a contact lens sensor. We also compared ocular volume curve parameters between normotensive and hypertensive patients, as well as between those with and without nocturnal blood pressure decline. Results: A total of 21 patients, including 7 normotensive and 14 treatment-naive hypertensive individuals, were included in the study. of them, 11 were dippers and 10 were non-dippers. No significant difference in the 24-h ocular volume slope was observed between the hypertensive and normotensive patients (p=0.284). However, dippers had a significantly higher 24-h ocular volume slope (p=0.004) and nocturnal contact lens sensor output (p=0.041) than non-dippers. Conclusion: Nocturnal blood pressure decline, rather than the blood pressure level, is associated with the increased 24-h ocular volume slope and nocturnal ocular volume. Further studies are required to determine whether the acceleration of glaucoma progression in dippers is primarily due to low blood pressure, high intraocular pressure, or a combination of both.

Corneal endothelial density and morphology in long-term soft contact lens users in Japan: a retrospective cross-sectional study of 17,732 eyes.

PURPOSE: There is a lack of long-term and large-scale studies on the adverse effects of soft contact lenses (SCLs) on the corneal endothelia of Asian populations. Here, we aimed to examine the effects of long-term SCL use on corneal endothelial density and morphology. MATERIALS AND METHODS: This retrospective study involved consecutive patients at the Miyata Eye Hospital (Miyazaki, Japan), who had used SCLs for more than 1 year. Patients with ophthalmological disorders without refractive errors were excluded. The period of SCL use, SCL type, corneal endothelial cell density (ECD), appearance rate of hexagonal cells (HEX), and coefficient of variation of cells (CV) were analyzed. RESULTS: In total, 17,732 eyes of 8866 patients were included in the analysis (age, 26.0 ± 8.8 years). The mean period of SCL use was 6.3 ± 5.4 years. Multivariate regression analysis revealed that ECD and HEX were significantly negatively correlated with the period of SCL use, age, and sex (p < 0.001 for all). The CV was significantly positively correlated with the period of use (p < 0.001), sex (p = 0.002), and age (p < 0.001). CONCLUSIONS: Corneal ECD, HEX, and CV were significantly associated with the period of SCL use in long-term users. It is essential to regularly check the corneal endothelium in patients with a history of long-term SCL use.

A Case of Bacterial Keratitis in a Patient Using Orthokeratology and Soft Contact Lenses.

A 63-year-old male with high myopia developed sudden visual loss, eyelid swelling, eye pain, discharge, and tearing in his left eye while wearing soft contact lenses (CLs) during the day and orthokeratology lenses at night. At the initial visit, his corrected visual acuity in the left eye was 20/1000, with a ring-shaped ulcer in the central cornea, corneal infiltration across the entire cornea, and conjunctival hyperemia. Pseudomonas aeruginosa was detected from corneal scrapings, and after antibiotic treatment, the ulcer healed with corneal opacity remaining. On the 60th day, corrected visual acuity of 20/20 was achieved with rigid gas-permeable CLs. To prevent CL-related ocular complications, eye care professionals must carefully evaluate the suitability of all CLs, including orthokeratology.

Evaluation of ciliary body cysts in candidates for phakic lens implantation.

PURPOSE: Phakic lens implantation in the ciliary sulcus of the eye can be complicated by coincident ciliary body cysts (CBC). We developed an ultrasound imaging and mapping protocol for these cysts. METHODS: This is a retrospective case series of all patients who underwent ICL workup at a single institution from April 2015 to October 2019. A standardized ultrasound biomicroscopy (UBM) imaging protocol was developed to screen for CBCs in either the ciliary body or sulcus. The locations and dimensions of all CBCs were graphically represented. RESULTS: The prevalence of CBCs in 158 patients undergoing ICL workup was 34.8%. Among the 159 CBCs detected in 55 patients, 83 were in the sulcus (52%) and 76 were restricted to the ciliary body (48%). ICLs were implanted in 40 eyes with CBCs and 3 eyes with CBCs located within the sulcus horizontally required ICL repositioning due to ICL rotation or iris chafing. CONCLUSION: CBCs were incidentally found in 34.8% of patients undergoing ICL workup. ICL implantation was complicated in 3 of the eyes with CBCs in the horizontal sulcus. Although CBCs are not an absolute contraindication for ICL surgery, we recommend preoperative UBM screening of the ciliary sulcus.

The relationship between contact lens ultraviolet light transmittance and myopia progression: a large-scale retrospective cohort study.

Background: The prevalence of myopia is increasing dramatically around the world, and many studies have suggested the possibility that ultraviolet (UV) light is effective to prevent the onset and progression of myopia. However, UV is a risk factor for diseases that cause refractive errors such as cataract and pterygium. In this study, we evaluated the relationship between UV exposure and myopia progression. Methods: The dataset consisted of a total of 337 396 eyes of patients in the 12-to-29-year age range, who were prescribed soft contact lenses (SCL) for refractive error at Okada Eye Clinic in Japan between 2002 and 2011. They were tracked over a five-year period and did not change the type of SCL. In this retrospective cohort study based on medical records, we divided patients into two groups, one prescribed SCL with UV protection (UV-SCL), and another prescribed SCL without UV protection (UV + SCL). Results: Change in refractive power over five years was measured and results compared. It was -0.413 diopter (D) in the UV-SCL group and -0.462 D in the UV + SCL group. Thus, the progression of myopia was slower in the UV-SCL group. The results were also analyzed separately by gender and degree of myopia at the time of initial prescription, which all showed significant differences (P < 0.001). Conclusion: Results suggest that UV exposure may advance myopia. Further research is needed to investigate the underlying mechanisms that could explain this.

A Modification on Hoffman's Pocket Technique With Scleral Fixation of Intraocular Lens (IOL), Case Series of Unique Scenarios.

Purpose: The purpose of this study is to present our experience with Hoffman's SFIOL using double-armed Gore-Tex sutures (polytetrafluoroethylene) instead of 9.0 polypropylene suture method in four cases. Observation: In this case series article, we present our experience with Hoffman's SFIOL using double-armed Gore-Tex sutures (polytetrafluoroethylene) instead of 9.0 polypropylene sutures; the postoperative evaluation revealed well-centered IOL which did not exhibit any signs of instability in all four eyes, demonstrating a successful surgical outcome without observed complications. Conclusions and Importance: Hoffman's SFIOL using double-armed Gore-Tex could be safe and effective methods for cases with no adequate capsular support for the IOL implantation. Compared to prolene suture, Gore-Tex gives more tensile strength and requires less manipulation during surgery minimizing postoperative inflammation which could be a valuable option in the nearby future for similar cases.

Exploring Implementation of Reasonable Adjustments in Hospitals for People With Intellectual Disability: Using a Realist Lens.

AIM: To explore the factors influencing the implementation of reasonable adjustments in hospitals for people with intellectual disability: using a realist lens. DESIGN: A qualitative study using a realist lens. METHODS: Data collection involved one focus group interview and three semi-structured interviews with healthcare professionals working in hospital or community settings in September 2023. Data were analysed using qualitative content analysis and findings were mapped to the Context and Implementation of Complex Interventions (CICI) framework across the dimension's context, implementation and setting. RESULTS: Healthcare professionals support the provision of reasonable adjustments in acute hospitals as a person-centred approach to caring for people with intellectual disability. While reasonable adjustments are evident in practice, they are mostly individual-level cases with little evidence of strategic system-level implementation. The factors influencing the implementation of reasonable adjustments in practice were conceptualised using the CICI framework. Context factors spanned the domains of epidemiological (e.g., ageing population), socio-cultural (e.g., historical healthcare), political (e.g., lack of integrated care pathways) and ethical (e.g., provision of person-centred care). Implementation factors spanned the domains of strategies (e.g., leadership strategies), agents (e.g., liaison and advocacy roles) and outcomes (e.g., individual-level reasonable adjustments). The setting for the complex intervention was the acute hospital. System-level indicators for successful implementation include intellectual disability specific policies/procedures for integrated care pathways, education and awareness training for hospital staff, and leadership strategies such as the development of liaison nursing roles and the appropriate allocation of physical and human resources. CONCLUSION: A radical change is needed where implementation of reasonable adjustments in acute hospitals are broadened beyond isolated individual-level cases to system-level healthcare. This research highlights the importance of exploring the integrated dimensions of context, implementation and setting in complex interventions such as reasonable adjustments and sets foundation for further implementation research in this area. IMPACT: Reasonable adjustments at the system-level within acute hospitals would promote person-centred care and help address the inequities and health disparities experienced by people with intellectual disability. This research uses a realist lens to explore the factors influencing the implementation of reasonable adjustments in acute hospitals for people with intellectual disability. The factors influencing the implementation of reasonable adjustments in practice were conceptualised using the CICI framework across the dimensions of context (domains epidemiological, socio-cultural, political and ethical), implementation (domains strategies, agents and outcomes) and setting. System-level indicators for successful implementation include intellectual disability specific policies/procedures for integrated care pathways, education and awareness training for hospital staff, and leadership strategies such as the development of liaison nursing roles and the appropriate allocation of physical and human resources. This research highlights the importance of exploring the integrated dimensions of context, implementation and setting of complex interventions such as reasonable adjustments and sets a foundation for further implementation research in this area. REPORTING METHOD: This research adhered to the Equator research reporting guideline: standards for reporting qualitative research. PATIENT OR PUBLIC CONTRIBUTION: A parent of a child with intellectual disability was involved in the conduct of this research, specifically in the design, data collection and preparation of the manuscript.

Analysis of the antigenic and immunogenic properties of the native rabies virus glycoprotein purified by Lens culinaris lectin affinity chromatography.

Rabies virus glycoprotein (RABV-G) is responsible for the recognition of specific cell surface receptors and induces the production of neutralizing antibodies (VNA). Since RABV-G is a glycoprotein, this work aimed to evaluate Lens culinaris (LCA) chromatography as a simple and effective purification method. The purity and identification of the protein obtained were analyzed by SDS-PAGE, ELISA and lectin-binding assay. The antigenic properties of the purified RABV-G were evaluated by direct ELISA using human serum samples from individuals who had received rabies pre-exposure vaccination. For the immunogenicity study, Swiss Webster mice were immunized with purified RABV-G and the specific antibodies were measured by direct ELISA and RFFIT. As results, it was observed that the purified protein reveled a molecular mass of 55 kDa and the presence of carbohydrate; additionally, it was recognized by anti-rabies virus glycoprotein monoclonal antibody. Purified RABV-G induced high VNA titers (>50.0 IU/ml) in vivo, as detected by RFFIT, as well as RABV-G specific IgG1 (0.8 mean OD±SD) and IgG2a (0.3 mean OD±SD) antibodies, with a predominance of IgG1 (p< 0.001). In addition, it was observed that RABV-G was efficient in selectively detecting anti- RABV-G IgG in the sera of vaccinated individuals compared to the negative control. Therefore, LCA chromatography was efficient in preserving the native properties of RABV-G that are essential in inducing an adequate humoral immune response. In addition, the purified RABV-G presented analytical potential as an ELISA reagent.

Histopathologic findings of the lens capsule and persistent hyperplastic primary vitreous in Korean pediatric cataract patients.

This study aimed to measure lens capsule thickness and investigate histopathologic characteristics of persistent hyperplastic primary vitreous (PHPV) in Korean pediatric cataracts. We analyzed lens capsules from 116 eyes of 83 pediatric cataract patients treated between 2011 and 2015. The mean thickness of the anterior/posterior capsule was 7.21 ± 1.74/4.39 ± 1.41 µm. PHPV was observed in 11.2% (13/116) of eyes. Histologic examination revealed that PHPV is typically characterized by retrolenticular membranes with hypercellular membrane tissue comprising vascular structures and/or mesenchymal cells, seen in 69% of cases. Only 3 patients had hyaloid arteries and endothelium-lined blood vessels in the retrolenticular membranes, whereas six eyes showed only mesenchymal cells. Lens capsule thickness did not significantly vary with age or the presence of PHPV in Korean pediatric cataracts. The primary histological characteristic of PHPV was the presence of mesenchymal cells, with or without vascular structures, supporting the role of endothelial-mesenchymal transition as a key mechanism in vascular regression.

Minimizing Oxidative Stress in the Lens: Alternative Measures for Elevating Glutathione in the Lens to Protect against Cataract.

Oxidative stress plays a major role in the formation of the cataract that is the result of advancing age, diabetes or which follows vitrectomy surgery. Glutathione (GSH) is the principal antioxidant in the lens, and so supplementation with GSH would seem like an intuitive strategy to counteract oxidative stress there. However, the delivery of glutathione to the lens is fraught with difficulties, including the limited bioavailability of GSH caused by its rapid degradation, anatomical barriers of the anterior eye that result in insufficient delivery of GSH to the lens, and intracellular barriers within the lens that limit delivery of GSH to its different regions. Hence, more attention should be focused on alternative methods by which to enhance GSH levels in the lens. In this review, we focus on the following three strategies, which utilize the natural molecular machinery of the lens to enhance GSH and/or antioxidant potential in its different regions: the NRF2 pathway, which regulates the transcription of genes involved in GSH homeostasis; the use of lipid permeable cysteine-based analogues to increase the availability of cysteine for GSH synthesis; and the upregulation of the lens's internal microcirculation system, which is a circulating current of Na+ ions that drives water transport in the lens and with it the potential delivery of cysteine or GSH. The first two strategies have the potential to restore GSH levels in the epithelium and cortex, while the ability to harness the lens's internal microcirculation system offers the exciting potential to deliver and elevate antioxidant levels in its nucleus. This is an important distinction, as the damage phenotypes for age-related (nuclear) and diabetic (cortical) cataract indicate that antioxidant delivery must be targeted to different regions of the lens in order to alleviate oxidative stress. Given our increasing aging and diabetic populations it has become increasingly important to consider how the natural machinery of the lens can be utilized to restore GSH levels in its different regions and to afford protection from cataract.

Exploring Angiotensin II and Oxidative Stress in Radiation-Induced Cataract Formation: Potential for Therapeutic Intervention.

Radiation-induced cataracts (RICs) represent a significant public health challenge, particularly impacting individuals exposed to ionizing radiation (IR) through medical treatments, occupational settings, and environmental factors. Effective therapeutic strategies require a deep understanding of the mechanisms underlying RIC formation (RICF). This study investigates the roles of angiotensin II (Ang II) and oxidative stress in RIC development, with a focus on their combined effects on lens transparency and cellular function. Key mechanisms include the generation of reactive oxygen species (ROS) and oxidative damage to lens proteins and lipids, as well as the impact of Ang II on inflammatory responses and cellular apoptosis. While the generation of ROS from water radiolysis is well established, the impact of Ang II on RICs is less understood. Ang II intensifies oxidative stress by activating type 1 receptors (AT1Rs) on lens epithelial cells, resulting in increased ROS production and inflammatory responses. This oxidative damage leads to protein aggregation, lipid peroxidation, and apoptosis, ultimately compromising lens transparency and contributing to cataract formation. Recent studies highlight Ang II's dual role in promoting both oxidative stress and inflammation, which accelerates cataract development. RICs pose a substantial public health concern due to their widespread prevalence and impact on quality of life. Targeting Ang II signaling and oxidative stress simultaneously could represent a promising therapeutic approach. Continued research is necessary to validate these strategies and explore their efficacy in preventing or reversing RIC development.

Vat photopolymerization of multifunctional fresnel lenses for ocular management.

In this study, multifunctional Fresnel lenses were explored as a potential solution for correcting vision in patients with color vision deficiency (CVD) and high myopia. Current studies have primarily focused on color vision correction through the 3D printing of glasses and contact lenses. However, the potential of 3D-printed multifunctional devices, such as Fresnel lenses, goes beyond addressing a single vision correction issue. For this study, computer-aided design (CAD) model of Fresnel lens with high diopter based on constant height configuration was developed. The CAD model was successfully fabricated using vat photopolymerization 3D printer, employing laboratory-prepared transparent HEMA resin. The resin was modified with two Atto dyes (565 nm and 488 nm), known for their ability to filter out problematic wavelengths (400-500 nm and 540-580 nm) to address color vision deficiency. The printed lenses were characterized by their chemical, physical, and optical properties using various characterization techniques. The focusing performance was evaluated using focal length measurements, and the results obtained were less than 2 mm deviation from the design value, having the potential to assist in higher myopic vision correction. The resulting optical spectra were compared with commercial glasses, revealing close agreement for CVD correction. These results expand the potential applications of multifunctional Fresnel lenses in ophthalmology, demonstrating their effectiveness as vision-correcting lenses and imaging systems.

The Clareon Vs AcrySof PanOptix Trifocal IOL: A Comparative Study of Patient Satisfaction and Visual Performance.

Purpose: To evaluate patient-reported outcomes of cataract surgery using the Clareon Panoptix and Panoptix Toric trifocal lenses and to compare these to the data collected previously for the AcrySof Panoptix and Panoptix Toric. Patients and Methods: Prospective, open-label, multicenter analysis of satisfaction, spectacle independence, presence of unwanted side effects, and best-corrected visual acuity among patients undergoing cataract surgery who had been implanted at least 1 month previously with the Clareon PanOptix or PanOptix Toric trifocal IOL bilaterally. Results were compared to outcomes measured two years ago from a similar study with the AcrySof version of the same lens. Results: No significant differences in patient satisfaction rates were reported between the two cohorts. Spectacle independence was similar with 88% of Clareon Panoptix and 83% of AcrySof Panoptix patients having no need for any corrective lenses. Quality of vision was not statistically different with 7% of Clareon vs 15% of AcrySof patients reporting "very much" or more of glare/halo severity. Significantly more AcrySof (66%) than Clareon (42%) patients achieved a spherical equivalent outcome within 0.25 D of target. Best corrected distance visual acuity differences were not statistically significant, and no safety concerns were reported. Conclusion: The Clareon PanOptix trifocal lens provides similar satisfaction and spectacle independence and has a similar side effect profile and BCVA outcome to the identical lens made of the predecessor AcrySof lens.

In this prospective, non-interventional, open-label, multicenter analysis evaluating patient-reported outcomes 1 month after scheduled cataract surgery, patients had similar satisfaction and spectacle independence with the Clareon PanOptix and PanOptix Toric trifocal lenses when results were compared to a previous study of the same lenses made of the predecessor AcrySof lens.

Target-specified reference-based deep learning network for joint image deblurring and resolution enhancement in surgical zoom lens camera calibration.

BACKGROUND AND OBJECTIVE: For the augmented reality of surgical navigation, which overlays a 3D model of the surgical target on an image, accurate camera calibration is imperative. However, when the checkerboard images for calibration are captured using a surgical microscope having high magnification, blur owing to the narrow depth of focus and blocking artifacts caused by limited resolution around the fine edges occur. These artifacts strongly affect the localization of corner points of the checkerboard in these images, resulting in inaccurate calibration, which leads to a large displacement in augmented reality. To solve this problem, in this study, we proposed a novel target-specific deep learning network that simultaneously enhances both the blur and spatial resolution of an image for surgical zoom lens camera calibration. METHODS: As a scheme of an end-to-end convolutional deep neural network, the proposed network is specifically intended for the checkerboard image enhancement used in camera calibration. Through the symmetric architecture of the network, which consists of encoding and decoding layers, the distinctive spatial features of the encoding layers are transferred and merged with the output of the decoding layers. Additionally, by integrating a multi-frame framework including subpixel motion estimation and ideal reference image with the symmetric architecture, joint image deblurring and enhanced resolution were efficiently achieved. RESULTS: From experimental comparisons, we verified the capability of the proposed method to improve the subjective and objective performances of surgical microscope calibration. Furthermore, we confirmed that the augmented reality overlap ratio, which quantitatively indicates augmented reality accuracy, from calibration with the enhanced image of the proposed method is higher than that of the previous methods. CONCLUSIONS: These findings suggest that the proposed network provides sharp high-resolution images from blurry low-resolution inputs. Furthermore, we demonstrate superior performance in camera calibration by using surgical microscopic images, thus showing its potential applications in the field of practical surgical navigation.

Application of transgenic mice to the molecular pathogenesis of cataract.

One of the most prevalent disorders that cause blindness worldwide is cataract, and its essence is the visual disorder caused by the opacity of the lens. The significant degree of variation in cataracts and the fact that a variety of factors can impact a patient's lens transparency make it especially crucial to investigate the pathogenesis of cataracts at the molecular level. It has been found that more than 60 genes are linked to the formation of cataracts, and the construction of a transgenic mouse model of cataract similar to the selection of human lens clouding due to a variety of causes has become an important means of studying the pathogenesis of cataract. Therefore, the research on the application of transgenic mice to the molecular pathogenesis of cataracts will be the main topic of this review of the literature.