Lens subluxation combined with parry-romberg syndrome: case report.

BACKGROUND: Parry-Romberg syndrome (PRS) is a rare progressive degenerative disorder of unknown etiology. Here we report a rare case of PRS combined with lens subluxation in Eye and ENT hospital of Fudan University, Shanghai. To our knowledge, it is the first reported case of PRS combined with lens subluxation that has been managed surgically with phacoemulsification and CTR placement and IOL implantation in Shanghai. CASE PRESENTATION: A 60-year-old woman was referred for "right visual blur for 2 years" and had persistent right facial paralysis of unknown etiology since the age 12. She had right facial muscle atrophy and paralysis. Eye examination also showed the right eyelid pseudoptosis, enophthalmos, age-related cataract combined with lens subluxation existed in the right eye. The patient was diagnosed as age-related cataract and lens subluxation in the right eye and progressive hemifacial atrophy (Parry-Romberg syndrome). We conducted a combined phacoemulsification, IOL and CTR implantation and pupilloplasty surgery for the patient under general anesthesia and the postoperative UCVA was 20/30 and remained for 1 year's follow up. CONCLUSIONS: Here we reported a rare case of PHA combined with lens subluxation in China. After appropriate eye surgery, the patient achieved satisfying vision result in the right eye.

Intravitreal injection of EV11, a novel aryl ketone amide, inhibits choroidal neovascularization via AKT/ERK1/2 pathway.

PURPOSE: Choroidal neovascularization (CNV) is the major cause of irreversible vision loss associated with age-related macular disease (AMD). The currently clinical chemical therapeutic strategies are of high cost and facing supply chain shortage. In our study, we aim to investigate EV11, a novel derivative from Sorafenib, as a new approach to inhibit the formation of CNV. METHODS: Cell viability assay, wound healing assay, transwell assay and tube formation assay were applied to explore the effects of EV11 on human vascular endothelial cells (HUVECs). Western blotting analysis was performed to investigate the pathways when EV11 acts on HUVECs. Laser-induced CNV in mice and intravitreal injection of EV11 were applied to find out the efficacy of the drug in vivo. Histological examination and electroretinogram (ERG) evaluated the retinal morphology and visual function after drug application. RESULTS: EV11 influenced the HUVECs cell viability as the concentration increasing after 24 hour incubation. It influenced HUVECs through suppressing AKT and ERK1/2 pathway. EV11 reduced CNV area with the optimal concentration of 200uM in mice eyes and compared with Bevacizumab, it had the same effect. The retinal thickness around the optic in each group was not influenced. The amplitudes of the a- and b-waves on scotopic and photopic ERG were not reduced after intravitreal injection. CONCLUSION: The present study indicated that EV11 affected the proliferation, migration and tube formation of HUVECs, inhibited the area of neovascular of laser induced choroidal neovascularization in mice eyes with no toxicity. EV11 could block the AKT/ERK1/2 signaling pathway in effects of HUVECs. This study unveiled a novel perspective drug EV11 to be a potential candidate for neovascularization.

Evaluation of the B/F Ratio Distribution of Cataract Patients Without Corneal Abnormalities and Its Effect on Ocular Parameters.

PURPOSE: To evaluate the distribution of the posterior-anterior corneal radius ratio (B/F ratio; posterior corneal radius/anterior corneal radius) in patients without corneal abnormalities, and to investigate which parameters affect this ratio. METHODS: Five thousand eyes from 5,000 patients who underwent cataract surgery were recruited to this study. We explored the linear relationship between B/F ratio and 13 variables using Principal Component-Multivariate Linear Regression Analysis. RESULTS: The B/F ratio was negatively correlated with the difference between simulated keratometry (SimK) and true net power (TNP), central corneal thickness, spherical aberration (SA), and posterior corneal astigmatism and positively correlated with posterior corneal radius, corneal posterior surface, axial length (AL) and anterior corneal radius. Several variables (central corneal thickness, difference between SimK and TNP and asphericity coefficient (Q-value) of the posterior corneal surface) had the highest loading on the final score. B/F ratio reflects the refractive state and anatomical structure of the cornea: thus, higher B/F ratios were associated with larger posterior corneal surface curvature radius, longer axial length, thinner central corneal thickness, lower high order aberrations of the cornea and SA, and the numerical difference between simK and TNP gradually reduced. In clinical practice, for patients with lower B/F ratio, special care should be taken in the choice of system used for intraocular lens (IOL) measurements.

Associations of polymorphisms in LOXL1 and copper chaperone genes with pseudoexfoliation-syndrome-related cataract in a Chinese Uygur population.

PURPOSE: To investigate the associations between single-nucleotide polymorphisms (SNPs) in the lysyl oxidase-like 1 (LOXL1) gene and copper chaperone genes and pseudoexfoliation-syndrome-related cataract (PEXC) in a Chinese Uygur population. METHODS: A case-control study was performed at the Second People's Hospital of Kashgar. Venous blood DNA was obtained from 70 patients with PEXC and 70 patients with age-related cataract (ARC). The exonic sequences of the LOXL1, antioxidant 1 copper chaperone (ATOX1), cytochrome C oxidase 17 copper chaperone (COX17), and copper chaperone for superoxide dismutase (CCS) genes were determined by Sanger sequencing, followed by a genetic association study. SIFT and PolyPhen-2 were used to predict the functional effects of the SNPs detected. The protein levels of CCS in lens-capsule specimens were measured by Western blotting. The plasma level of the CCS protein was measured using an enzyme-linked immunosorbent assay. RESULTS: Two coding SNPs (rs1048661 and rs3825942) in LOXL1 gene and a non-synonymous risk variant in CCS gene: CCS (c.717C>G, p.Asn239Lys) were significantly associated with PEXC. The TT genotype of rs1048661 was protective against PEXC in this Uygur population. The GG genotype of rs3825942 and its G allele were associated with an increased risk of PEXC. The CC genotype of c.717C>G and its C allele were protective against PEXC. The plasma level of CCS was significantly lower in patients with PEXC compared with those with ARC. CONCLUSIONS: The rs3825942 SNP of LOXL1 was strongly associated with PEXC in this Uygur population in China. CCS variants may represent a risk factor for PEXC. Our findings expand the understanding of the genetic base of PEXC.

The identification and characterization of the p.G91 deletion in CRYBA1 in a Chinese family with congenital cataracts.

BACKGROUND: Mutations in more than 52 genes have been identified in isolated congenital cataracts, the majority of which are located in crystalline and connexin (gap junction) genes. An in-frame one amino acid deletion in the beta-crystalline gene CRYBA1 has been reported in several different Chinese, Caucasian and Iranian families of congenital cataracts. Further functional studies are needed to confirm the variant pathogenicity. METHODS: The purpose of this study is to identify the genetic causes that contribute to congenital cataracts with esotropia and nystagmus in a Chinese family. Whole-exome sequencing was performed on samples from all five family members. The two brothers of the father and their daughters were then enrolled in the study, and 40 suspected variants were sequenced among the 9 subjects using Sanger sequencing. The mRNA and protein levels of CRYBA1 in the lens epithelium from cataract patients and normal controls were compared using quantitative polymerase chain reaction (qPCR) and Western blot analyses. The wild-type and mutated forms (p.G91del) of CRYBA1 cDNA were transfected into two types of cell lines, and the expression level of exogenous CRYBA1 was measured by Western blot analysis. The exogenous CRYBA1 proteins were visualized by immunofluorescence staining. RESULTS: In this two-generation family, all three descendants inherited congenital cataracts with esotropia and nystagmus from the father, while the mother's lens was normal. After two rounds of sequencing, CRYBA1 (c. 269-271 del, p.G91del) was identified as the mutation responsible for the autosomal dominant congenital cataract in the Chinese family. CRYBA1 showed lower expression in cataract lenses than in control lenses. The deleted form (p.G91del) of CRYBA1 showed lower expression and was more aggregate to the cell membrane than the wild-type CRYBA1. CONCLUSIONS: We performed molecular experiments to confirm that the p.G91del mutation in CRYBA1 results in abnormal expression and distribution of CRYBA1 protein, and this study could serve as an example of the pathogenicity of an in-frame small deletion in an inherited eye disorder.

Cyclodialysis cleft repair and cataract management by phacoemulsification combined with internal tamponade using modified capsular tension ring insertion.

PURPOSE: To evaluate the surgical outcomes of cyclodialysis cleft repair and cataract management by phacoemulsification combined with internal tamponade using a modified capsular tension ring (MCTR) compared with direct cyclopexy. METHODS: The preoperative and postoperative characteristics of patients with cyclodialysis clefts who underwent surgery via insertion of an MCTR into the ciliary sulcus (MCTR group; 16 patients, 16 eyes) or direct cyclopexy (DC group; 16 patients, 16 eyes) were recorded. RESULTS: The cyclodialysis extended over 2.6 ± 1.9 clock hours in the MCTR group and 3.5 ± 1.8 clock hours in the DC group (P = 0.094). Postoperatively, the IOP was not significantly different between the MCTR and DC groups (12.9 ± 3.7 mmHg vs. 13.8 ± 6.2 mmHg, P = 0.985); the logarithm of the minimal angle of resolution BCVA was better (0.1 ± 0.2 vs. 1.0 ± 0.9, P < 0.001), and the anterior chamber depth was greater (3.87 ± 0.40 mm vs. 2.59 ± 0.58 mm, P < 0.001) in the MCTR group than in the DC group. Compared with the preoperative parameters, the postoperative BCVA, IOP, and anterior chamber depth values were significantly improved in the MCTR group (P < 0.05), whereas the BCVA showed no significant improvement postoperatively in the DC group (P = 0.174). Logistic regression revealed no significant risk factors for successful IOP control or BCVA improvement. CONCLUSION: Phacoemulsification combined with internal tamponade using MCTR insertion into the ciliary sulcus is a safe and minimally invasive method for effectively closing cyclodialysis clefts and managing cataract.

Cionni-modified capsular tension ring for surgical repair of cyclodialysis after trabeculectomy: a case report.

BACKGROUND: To report a case for repair of cyclodialysis after trabeculectomy with Cionni-modified capsular tension ring. CASE PRESENTATION: A 64-year-old man who had undergone trabeculectomy of his left eye 3 months earlier visited our clinic owing to blurred vision. His visual acuity was 20/2000 and the intraocular pressure (IOP) was 6 mmHg. Slit-lamp examination showed a shallow anterior chamber and dense cataract. Ultrasound biomicroscopy revealed 360 ° detachment of the ciliary body and suspected cyclodialysis of the trabeculectomy incision. Choroidal detachment was confirmed by B-scan ultrasonography and optical coherence tomography. Phacoemulsification was performed in which a foldable intraocular lens (IOL) was implanted in the capsular bag and a Cionni-modified capsular tension ring (MCTR) was inserted into the ciliary sulcus. The maximum focal point of the MCTR was rotated to the site of the most severe cyclodialysis and the MCTR was sutured to the sclera through its two eyelets. The patient's best-corrected visual acuity improved to 30/50 and the IOP increased to 16 mmHg after surgery. Gonioscopy and ultrasound biomicroscopy confirmed closure of the cyclodialysis and resolution of choroidal detachment. CONCLUSIONS: Phacoemjulsification with implantation of an intraocular lens combined with insertion of an MCTR into the ciliary sulcus appears to be a relatively safe, effective, minimally invasive method for repairing cyclodialysis in cataract patients. Although the technique yielded good results and appeared to be safe in one patient, further studies are necessary to validate the findings on more patients and with a long-term follow-up.

Study on Spontaneous Combustion Characteristics and Oxidation Kinetic Parameters of Lignite at Different Oxygen Concentrations.

The spontaneous combustion parameters of lignite at different oxygen concentrations and temperatures were studied by temperature-programmed oxidation experiments. The characteristic parameters, tendency, oxygen consumption rate, kinetic parameters of oxidation reaction, and heat release intensity of coal's spontaneous combustion were studied. The results show that the variation of export oxygen volume fraction of coal samples under different oxygen concentrations is similar. It has a general s-shaped downward trend. The change trend of the CO concentration of the coal sample export is basically the same at different oxygen concentrations. The CO concentration at the outlet of the coal sample increases with the increase in coal temperature. The CO concentration at 0-200 °C increased exponentially with the coal temperature. The distribution pattern of CO/CO2 ranging from 0 to 320 °C was similar at different oxygen concentrations. With the increase of coal temperature, CO/CO2 first increases and then decreases after reaching the extreme point. The change curve of CH4 with coal temperature under different oxygen concentrations meets the exponential change rule. At different oxygen concentrations, the concentration of ethylene at 0-300 °C changes exponentially, but at 300-400 °C there is no rule. When the oxygen concentration is 20.9%, according to the comprehensive judgment index method and cross temperature method, the comprehensive determination of the spontaneous combustion trend of coal samples is grade II. Under different oxygen concentrations, the oxygen consumption rate of coal increases with the increase of temperature; the oxygen consumption rate increases with the increase of oxygen concentration at the same temperature. The activation energy of coal samples increases with the decrease of oxygen supply concentration or the increase of temperature. The thermal strength of the coal sample is consistent with the change trend of the oxygen consumption rate. The heat release intensity of coal samples conforms to an exponential function and polynomial function in the early and late stages, respectively.

Analysis of Corneal Spherical Aberrations in Chinese Bilateral Ectopia Lentis Patients.

Purpose: To analyze the anterior, posterior, and total corneal spherical aberrations (ASA, PSA, and TSA) in patients with Chinese bilateral ectopia lentis (EL). Methods: A cross-sectional study was conducted to evaluate corneal spherical aberration (CSA) using a Pentacam system at the 6-mm optical zone. Axial length, keratometry, astigmatism, and corneal asphericity were also determined. Results: This study included 247 patients (420 eyes) with a mean age of 18.1 years. The values of ASA, PSA, and TSA were 0.136 ± 0.100 µm, -0.118 ± 0.030 µm, and 0.095 ± 0.095 µm, respectively. In the EL patients with Marfan syndrome (MFS), ASA and TSA were significantly lower than in the non-MFS patients (0.126 ± 0.094 µm vs. 0.155 ± 0.107 µm, P = 0.004 for ASA; 0.085 ± 0.091 µm vs. 0.114 ± 0.099 µm, P = 0.003 for TSA), whereas PSA was not significantly different (P = 0.061). The values of ASA and TSA were significantly higher in the patients with EL aged ≥ 40 years old than in younger patients, whereas ASA and PSA were lower in patients aged <10 years old than in older patients (all P < 0.05). In the multiple linear regression analysis, age, keratometry, astigmatism, anterior asphericity, higher-order aberration (HOA), and lower-order aberration (LOA) were positively or negatively correlated with TSA in the patients with EL (r = 0.681, P < 0.001). Conclusions: Corneal spherical aberration was low in the patients with EL especially for MFS and tended to increase with aging. Preoperatively, individual measurement of CSA was necessary for bilateral EL patients with MFS.

Differential Effects of TGF-ß2 on the Low-Density Lipoprotein Receptor Expression in Three Types of Human Subconjunctival Fibroblasts.

Purpose: To investigate whether TGF-ß2 had a different effect on the expression levels of low-density lipoprotein receptor (LDLr) in the subconjunctival fibroblasts from glaucoma patients who underwent a reoperation (RGSFs) compared with those from glaucoma patients who underwent first filtering surgery (GSFs) and control patients with cataracts (HSFs). Methods: Human subconjunctival fibroblasts were obtained from the three groups of patients. Different concentrations of TGF-ß2 were added to the fibroblasts for 1, 3, and 5 days. The proliferation of the fibroblasts was determined by CCK-8 assays. Real-time PCR and western blotting were performed to analyze the mRNA and protein levels of LDLr. The uptake of DiI-labeled LDL was determined by confocal microscopy. Results: The results revealed that under TGF-ß2 exposure, fibroblast proliferation was positively correlated with LDLr expression (all p < .001). The LDLr mRNA and protein levels were affected by TGF-ß2 in a concentration-dependent and time-dependent manner in the RGSFs, GSFs and HSFs. The maximal expression of LDLr after TGF-ß2 stimulation was consistent with the peak uptake of DiI-LDL, which was obviously highest in the RGSFs, followed by the GSFs, and then the HSFs (all p < .05). All 3 groups took up DiI-LDL in a similar time-dependent manner, with maximal uptake at 6 h following DiI-LDL incubation (all p < .05). In addition, there were significant differences in the LDLr protein levels in the subconjunctival tissues isolated from the glaucoma patients during reoperation, the glaucoma patients during first filtering surgery and the control patients at day 3 (p < .05). The highest protein expression of LDLr was observed in the RG group. Conclusion: These data suggested that the RGSFs had the highest LDLr expression and the highest peak uptake of LDL among three groups. The LDLr-drug-LDL delivery system could potentially be used for targeted delivery of antimetabolite agents in anti-scarring therapy for glaucoma patients after filtering surgery.

Ocular Manifestations of Acute Secondary Angle Closure Associated With Lens Subluxation.

PURPOSE: To evaluate the clinical characteristics and ocular features of patients with acute secondary angle closure, associated with lens subluxation (ASAC-LS). METHODS: We performed a retrospective study at the EENT Hospital of Fudan University, Shanghai, China. A total of 41 affected eyes from 41 patients were enrolled in this study. Furthermore, 20 affected eyes were part of the ASAC-LS cohort and 21 affected eyes were included in the acute primary angle closure (APAC) cohort. The best-corrected visual acuity (BCVA), intraocular pressure (IOP), axial length (AL), minimum corneal curvature (K1), maximum corneal curvature (K2), and anterior chamber depth (ACD) were measured and compared between the 2 cohorts. In addition, inter-eye (intraindividual) comparison was performed. RESULTS: The ASAC-LS cohort exhibited younger ages, more frequent trauma history (35%), lower IOP (27.43 ± 13.86 mmHg vs. 41.27 ± 10.36 mmHg), longer AL (23.96 ± 2.60 vs. 22.49 ± 0.77 mm), shallower ACD (1.28 ± 0.38 vs. 1.58 ± 0.23 mm), and bigger ACD differences (0.99 ± 0.52 vs. 0.15 ± 0.19 mm), as compared with the APAC cohort (all p < 0.05). Moreover, eyes from the lens subluxation cohort experienced worse BCVA, higher IOP, and shallower ACD than their matched unaffected eyes (all p < 0.05). Although longer AL, shallower ACD, and bigger ACD differences were strongly correlated with lens subluxation in a univariate logistic regression analysis, only the ACD difference remained significant in the multivariate model (p = 0.004, OR = 1,510.50). Additionally, according to the receiver operating characteristic (ROC) curve analysis, both ACD and ACD differences had greater value in the differential diagnosis of ASAC-LS and APAC, with a cut-off value of 1.4 and 0.63 mm, respectively. CONCLUSIONS: Shallower ACD and larger ACD differences provide the promising diagnostic potential for patients with ASAC-LS.

Adipose/Connective Tissue From Thyroid-Associated Ophthalmopathy Uncovers Interdependence Between Methylation and Disease Pathogenesis: A Genome-Wide Methylation Analysis.

In response to pathological stimulation, methylation status conversion of the genome drives changes of cell feature and is able to promote disease development. Yet the role of methylation in the development of thyroid-associated ophthalmopathy (TAO) remains to be evaluated. Overexpansion of orbital tissue is the key feature of TAO. In this study, the methylation profile of orbital adipose/connective tissue from TAO patients and normal individuals were compared. After screening 3,739 differentially methylated probes, the distribution and properties of these probes were analyzed. Furthermore, enriched biological functions of these genes associated with differential methylation and the relationship between their methylation status and expression profile were also identified, including PTPRU and VCAM-1. According to our results, methylation was involved in disregulated immune response and inflammation in TAO and might contribute to activation of fibroblast and adipogenesis, leading to the expansion of orbital tissue. Neuropathy and neurobehavioral symptoms were also potentially associated with methylation. These results may help to extend the understanding of methylation in TAO and provide more insights into diagnosis and treatment of patients.

Eyes of Aniso-Axial Length Individuals Share Generally Similar Corneal Biometrics with Normal Eyes in Cataract Population.

AIMS: To determine the characteristics of corneal biometrics in eyes from aniso-axial length cataract patients compared with eyes from non-aniso-axial length individuals. METHODS: This is a retrospective case series. Cataract patients with preoperative binocular measurements were recruited. A binocular axial difference of ≥1 mm was considered to indicate aniso-axial length. The anterior segmental biometrics were measured using Pentacam HR (Oculus, Wetzlar, Germany) and IOLMaster 500 (Carl Zeiss Meditec, Jena, Germany). Comparisons of biometrics were made among 4 eye conditions: the longer eyes from aniso-axial length patients, the shorter eyes from aniso-axial length patients, the longer eyes from non-aniso-axial length patients, and the shorter eyes from non-aniso-axial length patients. The aniso-axial length eyes were also stratified into 8 subgroups with axial length (AL) increments of 1 mm, and the biometrics of the subgroups were compared. RESULTS: There was smaller anterior corneal astigmatism in the shorter aniso-axial length group than those in the longer aniso-axial length group (1.01 ± 0.70 D vs 1.12 ± 0.76 D, P=0.031). The longer aniso-axial length eyes had greater anterior corneal steep curvature (44.13 ± 1.69 D vs 43.87 ± 1.69 D, P=0.009) and anterior corneal astigmatism (1.12 ± 0.76 D vs 1.02 ± 0.69 D, P=0.023) compared with longer non-aniso-axial length subjects. Other corneal biometrics were similar between the aniso-axial length eyes and the non-aniso-axial length eyes. In the longer aniso-axial length group, the posterior corneal aberrations of eyes in the ≥5 mm subgroups were greater than those in the <5 mm subgroups (0.879 ± 0.183 µm vs 0.768 ± 0.178 µm for total aberrations, P < 0.001; 0.228 ± 0.086 µm vs 0.196 ± 0.043 µm for high-order aberrations, P=0.036; 0.847 ± 0.173 µm vs 0.741 ± 0.179 µm for low-order aberrations, P=0.001). CONCLUSION: Eyes of aniso-axial length individuals share generally similar corneal biometrics with normal eyes in cataract population. Anterior corneal astigmatism of the longer eyes from the aniso-axial length cataract patients was higher than that of the longer eyes from the non-aniso-axial length individuals. Total posterior corneal aberrations of the longer aniso-axial length eyes increased when the binocular axial difference was over 5 mm.

Analysis of Corneal Spherical Aberrations in Cataract Patients with High Myopia.

To evaluate the corneal spherical aberrations in cataract patients with and without high myopia, we conducted a retrospective case series of 502 cataract eyes with high myopia and 1500 age-related cataract eyes and measure their corneal biometric data and axial length using Pentacam and IOLMaster. Both the anterior and total corneal primary spherical aberrations were lower in the high myopia group than that in the control group (0.317 ± 0.215 vs 0.338 ± 0.148 µm, P = 0.043; and 0.281 ± 0.207 vs 0.314 ± 0.153 µm, P < 0.001). The incidence of eyes with negative total corneal primary spherical aberration increased as axial length increased in the high myopia group, and the overall incidence was higher in the high myopia group than that in the control group (2.59% vs 1.47%). These were mainly contributed to the younger age of cataract patients with high myopia (55.76 ± 13.10 vs 60.18 ± 15.72 years, P < 0.001), along with the positive correlations between age and anterior and total corneal primary spherical aberrations. In clinical practice, an aspheric IOL with a low negative or zero primary spherical aberration is recommended for cataract patients with high myopia. Negative total ocular primary spherical aberrations resulting from aspheric IOL implantation should be avoided in extremely high myopic eyes.

Correlations of Corneal Spherical Aberration with Astigmatism and Axial Length in Cataract Patients.

PURPOSE: To clarify the distribution of corneal spherical aberrations (SAs) in cataract patients with different corneal astigmatism and axial length. SETTING: Department of Ophthalmology and Vision Science of the Eye and ENT Hospital of Fudan University, Shanghai, China. DESIGN: Retrospective case series. METHODS: The axial length, corneal SAs, and other corneal biometrics were collected in cataract patients with Pentacam HR and IOLMaster 500. The statistical analysis of the corneal SAs was based on the stratification of axial length and anterior corneal astigmatism. RESULTS: In total, 6747 eyes of 6747 patients were recruited, with 2416 eyes (58.17 ± 16.81 years old) in the astigmatism group (anterior corneal astigmatism ≥1 D) and others (61.82 ± 12.64 years old) in the control group. In patients with astigmatism <2 D, the total and anterior SAs decreased as the axial length increased (P < 0.001). The total corneal SAs of patients with astigmatism of 2-3 D stabilized at around 0.29 µm, whereas those of patients with anterior corneal astigmatism ≥3 D tended to be variable. Age and anterior corneal astigmatism had positive and negative effects, respectively, on SA in the regression model. CONCLUSIONS: Axial length has a negative effect on the anterior and total corneal SAs, which stabled around 0.33 µm and 0.30 µm in patients with axial length of ≥26 mm, respectively. Individualized SA adjustments are essential for patients undergoing aspheric toric IOL implantation with preoperative anterior corneal astigmatism of 1-2 D or ≥3 D. Toric IOLs with a negative SA of -0.20 µm are recommended for patients with anterior corneal astigmatism of 2-3 D if no customized therapy is warranted.

TRIM69 inhibits cataractogenesis by negatively regulating p53.

Ultraviolet B (UVB) irradiation can induce reactive oxygen species (ROS) production and apoptosis in human lens epithelial cells (HLECs), thus leading to the formation of cataracts. We studied the role of tripartite motif 69 (TRIM69) in cataract formation. The expression of TRIM69 protein was down-regulated in both human cataract capsule tissues and HLECs treated with UVB, whereas the expression of p53 protein exhibited an opposite trend. Ectopic expression of TRIM69 in HLECs significantly suppressed UVB-induced apoptosis and ROS production, whereas knockdown of TRIM69 promoted apoptosis and ROS production. TRIM69 can interact with p53 and induce its ubiquitination. The effects of TRIM69 overexpression in UVB-induced cell apoptosis and ROS production was clearly weakened by p53 overexpression, thus suggesting a role for p53 in TRIM69 functions. Furthermore, inhibition of ROS mitigated the effects of UVB irradiation on ROS production, cell apoptosis, forkhead box protein 3a (Foxo3a) phosphorylation, and TRIM69 expression. Additionally, Foxo3a overexpression significantly enhanced TRIM69 promoter activity, whereas Foxo3a knockdown had the opposite effect. In conclusion, we provide the first demonstration that Foxo3a is a potential transcription factor for TRIM69, and TRIM69 induces p53 ubiquitination. These results suggest that the Foxo3a/TRIM69/p53 regulatory network may be involved in cataract formation.

Analysis of corneal higher-order aberrations in cataract patients with high myopia.

PURPOSE: To evaluate the differences in corneal higher-order aberrations (HOAs) between cataract patients with high axial myopia and normal cataract patients, and to identify the associated factors. SETTING: Department of Ophthalmology and Vision Science of the Eye and ENT Hospital of Fudan University, Shanghai, China. DESIGN: Retrospective case series. METHODS: Corneal aberrations and axial lengths (ALs) were measured using a rotating Scheimpflug camera (Pentacam) and partial coherence interferometry (IOLMaster) in the high myopia group and the control group. RESULTS: The study comprised 287 patients (520 eyes). There were 194 eyes in the high myopia group and 326 eyes in the control group. The 5 anterior corneal aberrations-vertical coma, vertical trefoil, horizontal coma, oblique trefoil, and primary spherical aberration-in the high myopia group were 0.07 µm ± 0.38 (SD), -0.11 ± 0.23 µm, 0.07 ± 0.28 µm, -0.02 ± 0.18 µm, and 0.39 ± 0.19 µm, respectively. No negative primary spherical aberrations of the total or anterior corneal surface were found in the high myopia group. Differences between the 2 groups were found in terms of central corneal thickness, astigmatism, primary spherical aberration, vertical coma, and oblique trefoil; however, these differences were not consistent between different age subgroups. Higher-order aberrations were correlated with age. Posterior corneal vertical coma was correlated with AL (Pearson correlation = -0.188, P = .047). CONCLUSIONS: Negative primary spherical aberrations of the anterior or total corneal surface were not found in the high myopia group. Age showed a strong relationship with HOAs. For cataract patients with high myopia, aspheric intraocular lens implantation is recommended.

Distribution of posterior corneal astigmatism and aberration before cataract surgery in Chinese patients.

PURPOSE: To study the prevalence of posterior corneal astigmatism (PCA) and aberration in Chinese eyes before cataract surgery. METHODS: A cross-sectional study was conducted in Eye and ENT Hospital of Fudan University, Shanghai. In all, we enrolled 1976 eligible eyes of 1976 cataract patients. The astigmatism and aberrations of anterior and posterior cornea were measured by the rotating Scheimpflug System (Pentacam HR, Oculus). Cataract was diagnosed using slit-lamp examination. RESULTS: The mean age of patients was 61.82 ± 13.67 years old. Mean PCA was 0.28 ± 0.16 (range 0-1.0) D and 87.04% eyes had PCA values <0.5 D. WTR astigmatism predominated the anterior cornea astigmatism (43.1%), while ATR astigmatism predominated posterior (85.4%) and total corneal astigmatism (47.2%). We found a shift tendency of WTR to ATR with aging in anterior corneal astigmatism, while PCA remains ATR. A positive correlation between the magnitude of anterior and posterior corneal astigmatism (r2 = 0.089, P < 0.001) was found, especially in WTR anterior cornea astigmatism eyes (r2 = 0.298, P < 0.001). Compared with total corneal astigmatism, anterior corneal measurements overestimated WTR astigmatism by a mean of 0.24 ± 0.13 (D), and underestimated ATR astigmatism and oblique astigmatism in most eyes. Furthermore, anterior corneal aberrations measurements overestimated the total corneal aberration in most eyes. CONCLUSIONS: About 12.96% of eyes had PCA ≥0.5 D. The posterior surface remained ATR astigmatism in most cases with aging. Neglecting the posterior cornea would result in overestimation in WTR anterior corneal eyes and underestimation in ATR and oblique anterior corneal eyes. Also, the posterior corneal aberration was also essential in clinics.

Age Differences in Axial Length, Corneal Curvature, and Corneal Astigmatism in Marfan Syndrome with Ectopia Lentis.

PURPOSE: To investigate the differences in axial length, corneal curvature, and corneal astigmatism with age in patients with Marfan syndrome (MFS) and ectopia lentis. METHODS: A retrospective case series study was conducted. MFS patients with ectopia lentis were divided into groups according to age. Axial length, corneal curvature, and corneal astigmatism were measured. RESULTS: This study included 114 MFS patients (215 eyes) with a mean age of 19.0 ± 13.9 years. Axial length differed significantly across age groups in MFS patients (P < 0.001), whereas corneal curvature did not (P = 0.767). Corneal astigmatism was statistically significant throughout the MFS cohort (P = 0.009), but no significant difference was found in young MFS patients (P = 0.838). With increasing age, the orientation of the corneal astigmatism changed from with-the-rule astigmatism to against-the-rule or oblique astigmatism (P < 0.001). A linear correlation analysis showed weak correlations between age and axial length for both eyes and with corneal astigmatism for the left eye, but there was no correlation between age and corneal curvature. CONCLUSIONS: In MFS, axial length varies with age, corneal curvature remains stable, and corneal astigmatism is higher in young patients and tends to shift toward against-the-rule or oblique astigmatism. Therefore, it is important to consider age when diagnosing MFS with ocular biometric data.

Corneal Curvature, Astigmatism, and Aberrations in Marfan Syndrome with Lens Subluxation: Evaluation by Pentacam HR System.

Marfan syndrome (MFS) is associated with abnormalities of corneal biometric characteristics. We conducted a retrospective case-control study including 55 eyes of the MFS patients with lens subluxation and 53 normal eyes of the control subjects to evaluate the corneal curvature, astigmatism and aberrations using a rotating Scheimpflug camera (Pentacam HR). Compared with the control group, the anterior, posterior, and total corneal curvature were flatter in the MFS group. The anterior and total corneal astigmatism were higher in the MFS patients, whereas the posterior corneal astigmatism was not significantly different between the two groups. Regarding the total corneal aberrations, the root mean square (RMS) aberrations, RMS higher-order aberrations and RMS lower-order aberrations increased, whereas the spherical aberration decreased in the MFS patients. Corneal parameters had potential diagnostic values for MFS patients with lens subluxation and the more reasonable cutoffs were the values of corneal curvature <41.35 D, corneal astigmatism >0.85 D and spherical aberration <0.188 µm. Corneal biometric characteristics of MFS patients with lens subluxation include decreased corneal curvature, higher corneal astigmatism, larger corneal aberrations, and lower spherical aberration. Corneal curvature, corneal astigmatism, and spherical aberration are better diagnostic tools for suspicious MFS.