Retinal complications post posterior chamber phakic intraocular lens implantation at a tertiary eye hospital in the Eastern Province of Saudi Arabia.

PURPOSE: Phakic intraocular lenses treat higher degrees of myopia not possible previously with conventional refractive surgery. The aim of this study is to report the incidence and risk factors of retinal complications after posterior chamber PIOL implantation and assess the differences in biometric parameters between patients who developed such complications versus those who did not. METHODS: This retrospective study recruited 514 patients who underwent ICL implantation to correct myopia at a tertiary eye hospital center in the Eastern province of Saudi Arabia. Follow up period was at least one year. Medical records of the patients were reviewed to obtain the required data. Associations between respondents' characteristics and retinal complications were evaluated using the Chi-squared test. RESULTS: The mean (SD) age was 27.7 (± 6.5) years ranging from 18 to 47. Laser treatment was performed in 14 cases (2.7%). Retinal complications occurred in six cases (1.2%). The risk of retinal complication was significantly higher among patients with high axial length (OR = 1.3, 95% CI 1.2, 1.4) and patients with high pre-spherical equivalent before ICL (OR = 1.09, 95% CI 1.03, 1.4). CONCLUSION: Patients with higher axial length and higher pre-spherical equivalent before ICL implantation are at high risk of retinal complications.

Impact of removing soft contact lenses 1 day versus 1 month before surgery on the outcomes of microkeratome laser in situ keratomileusis.

PURPOSE: To compare the outcomes, safety, efficacy, and predictability of microkeratome laser in situ keratomileusis (LASIK) 24 h and one month or more after removing soft contact lenses. SETTING: ULTRALASIK Eye Center, Dubai, United Arab Emirates. METHODS: The patients were divided based on the time of discontinuation of the soft contact lenses before LASIK (Group 1 at 24 h and Group 2 at one month or longer), and the two groups were well matched. Schirmer's testing, tear break-up time, corrected distance visual acuity, uncorrected distance visual acuity, manifest refraction spherical equivalent, and infection rate were evaluated preoperatively and at one week, one month, and six months after treatment. RESULTS: Group 1 (G1) comprised 1025 eyes, and group 2 (G2) had 1052 eyes. The groups were comparable preoperatively. The overall-mentioned outcomes were comparable between groups with uncorrected distance visual acuity of - 0.084 ± 0.12 logMAR in G1 and - 0.078 ± 0.17 logMAR in the G2 at 6 months (P = 0.322). Tear break-up time as well as Schirmer's testing results was also comparable with no evidence of increased risk of dry eyes or non-inflammatory complications in any of the groups on follow-up visits at 1 week (P = 0.421), 1 month (P = 0.101), and 6 months (P = 0.399) postoperatively. Finally, no infectious complications were recorded in either of the groups. CONCLUSION: With the absence of corneal warpage, no statistical or clinical difference in microkeratome LASIK outcomes and safety was spotted between the groups despite the difference in SCL discontinuation time before the procedure.

Factors Predicting the Need for Re-treatment After Laser Refractive Surgery in Patients With Mixed Astigmatism.

PURPOSE: To identify risk factors that increase the likelihood of re-treatment following refractive surgery in patients with mixed astigmatism. METHODS: This was a retrospective study including patients who underwent either laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between 2000 and 2019 and had mixed astigmatism (spherical error of +0.50 D or greater and spherical equivalent of less than 0.00 diopters [D]). Patients were divided into two groups according to whether they underwent re-treatments during the study period. RESULTS: Overall, 785 eyes (785 patients) were included. In total, 5.2% of the eyes (n = 41) underwent re-treatment. The re-treatment group was more likely to have preoperative high astigmatism (80.5% vs 48.3%, P < .001), moderate to high hyperopia (36.6% vs 22.3%, P = .035), and to have undergone surgery earlier during the study period (P < .001). They were also more likely to have undergone surgery using the Wave-Light EX200 rather than the EX500 laser platform (Alcon Laboratories, Inc) (P < .001), have a treated optical zone of 6 mm rather than 6.5 mm (P < .001 for both), and their maximum ablation depth was greater (P < .001). There was no difference between the re-treatment and control groups regarding procedure type (PRK vs LASIK). Binary logistic regression found preoperative high astigmatism (odds ratio = 3.97, P < .001) and the type of laser platform used (EX200, odds ratio = 7.78, P < .001) as the only independent factors associated with re-treatment. CONCLUSIONS: Re-treatment rates following correction of mixed astigmatism were 5.2% over 20 years. Use of a sixth-generation laser platform significantly reduced the risk of re-treatment. Presence of high astigmatism is a significant risk factor for re-treatment. There was no difference in retreatment risk between PRK and LASIK. [J Refract Surg. 2024;40(2):e73-e78.].

A Mendelian randomization study on the causal relationship between smoking, alcohol consumption, and the development of myopia and astigmatism.

The influence of environmental factors like smoking and alcohol on myopia and astigmatism is controversial. However, due to ethical concerns, alternative study designs are urgently needed to assess causal inference, as mandatory exposure to cigarettes and alcohol is unethical. Following comprehensive screenings, 326 single nucleotide polymorphisms (SNPs) related to myopia and astigmatism were included in the dataset. To validate the causal association between exposures such as cigarette smoking, alcohol consumption, and coffee intake, and outcomes namely astigmatism and myopia, five regression models were employed. These models encompassed MR-Egger regression, random-effects inverse-variance weighted (IVW), weighted median estimator (WME), weighted model, and simple model. The instrumental variables utilized in these analyses were the aforementioned SNPs. Apply Cochran's Q test to determine heterogeneity of SNPs; if heterogeneity exists, focus on IVW model results. The IVW model showed a 1.379-fold increase in the risk of astigmatism (OR = 1.379, 95%CI 0.822~2.313, P = 0.224) and a 0.963-fold increase in the risk of myopia (OR = 0.963, 95%CI 0.666~1.393, P = 0.841) for each unit increase in smoking. For each unit increase in coffee intake, the risk of astigmatism increased 1.610-fold (OR = 1.610, 95%CI 0.444~5.835, P = 0.469) and the risk of myopia increased 0.788-fold (OR = 0.788, 95%CI 0.340~1.824, P = 0.578). For each additional unit of alcohol consumption, the risk of astigmatism increased by 0.763-fold (OR = 0.763, 95%CI 0.380~1.530, P = 0.446), and none of the differences were statistically significant. However, for each unit of alcohol consumption, the risk of myopia increased by 1.597 times, and the difference was statistically significant (OR = 1.597, 95%CI 1.023~2.493, P = 0.039). The findings indicate that alcohol consumption is a risk factor for myopia but smoking and coffee intake do not affect its development. Additionally, there is no association between smoking, alcohol consumption, coffee intake, and the risk of astigmatism.

Effect of 3% Diquafosol Sodium on Dry Eye After Femtosecond Laser-Assisted In Situ Keratomileusis and Small Incision Lenticule Extraction Surgery in High-Myopic Eyes.

PURPOSE: To evaluate the effect of 3% diquafosol sodium eye drop on dry eye after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) in high-myopic eyes. METHODS: Eighty-one cases with high myopia (162 eyes) who received FS-LASIK or SMILE were divided into four groups by surgical design and tear film stability: D-FS-LASIK (5s

Ray-tracing-guided myopic LASIK: real-world clinical outcomes.

PURPOSE: To assess effectiveness of individualized ray-trace based laser in situ keratomileusis (LASIK) for correction of myopia in everyday clinical practice. SETTING: Single-site private practice. DESIGN: Retrospective nonrandomised unmasked chart review. METHODS: Consecutive, myopic eyes (range ≤-8.25 diopters [D] sphere; astigmatism 0 to -4.25 D) treated with ray-trace based LASIK were included. Patients underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap diagnostic device. The ray-trace based algorithm (InnovEyes algorithm) then generated an individualized 3D eye model and calculated a customized LASIK ablation profile. Postoperative visual acuity, refractive error and whole eye higher-order aberrations (HOAs) were evaluated over 3 months. RESULTS: The procedure was performed on 400 eyes (200 patients). Mean preoperative manifest refraction spherical equivalent was -3.39 ± 1.58 D (right eye -3.84 ± 1.63 D, left eye -3.98 ± 1.75 D). At month 3, uncorrected distance visual acuity (UDVA) was ≥20/20 in all eyes, ≥20/16 in 89% (right eye 90%, left eye 89%), ≥20/12 in 51% (54% right eye; 47% left eye), and 20/10 in 8% (right eye 8%; left eye 9%) of eyes respectively. UDVA was within 1 line of preoperative corrected distance visual acuity in 98% of eyes (right eye 98.5%; left eye 98%) and 39% of eyes (right eye 38%; left eye 39%) gained 1 line improvement. There was a statistically but not clinically significant increase in total HOAs (right eye 0.06 ± 0.133 µm; left eye 0.057 ± 0.125 µm; P < .001). The spherical aberration decreased (right eye -0.047 ± 0.095 µm, P < .001; left eye -0.051 ± 0.091 µm, P < .001). CONCLUSIONS: Ray-trace based LASIK was safe and effective for correction of myopia with and without astigmatism. Approximately, half the eyes achieved ≥20/12.5 UDVA and 8% achieved 20/10. There was no clinically significant increase in total whole eye HOAs.

Comparison of implantation of posterior chamber phakic IOL implantation and laser vision correction in terms of corneal endothelial cells: 3-year observational paired-eye study.

PURPOSE: To compare the postoperative endothelial cell counts of EVO-implantable collamer lenses (ICLs) with a central hole (V4c and V5) and laser vision correction surgery (laser in situ keratomileusis or photorefractive keratectomy). SETTING: B&VIIT Eye Center, Seoul, South Korea. DESIGN: Retrospective observational and paired contralateral study. METHODS: 62 eyes of 31 patients who underwent EVO-ICLs with a central hole implantation in one eye (phakic intraocular lens [pIOL] group) and laser vision correction in the contralateral eye (LVC group) to correct refractive errors were retrospectively reviewed. Central endothelial cell density (ECD), percentage of hexagonal cells (HEX), coefficient of variation (CoV) in cell size, and adverse events were evaluated for at least 3 years. The endothelial cells were observed using a noncontact specular microscope. RESULTS: All surgeries were performed, without complications during the follow-up period. The mean ECD loss values compared with the preoperative measurements were 6.65% and 4.95% during the 3 years after pIOL and LVC, respectively. There was no significant difference in ECD loss compared with the preoperative values (paired t test, P = .188) between the 2 groups. No significant loss in ECD was observed at any timepoint. The pIOL group showed higher HEX ( P = .018) and lower CoV ( P = .006) values than the LVC group at the last visit. CONCLUSIONS: According to the authors' experience, the EVO-ICL with a central hole implantation was a safe and stable vision correction method. Moreover, it did not induce statistically significant changes in ECD at 3 years postoperatively compared with LVC. However, further long-term follow-up studies are required to confirm these results.

Analysis of Secondhand Smoke Exposure and Myopia Among Children Aged 6 to 8 Years in Hong Kong.

Importance: Secondhand smoke (SHS) exposure potentially threatens ocular health; however, its association with myopia is unknown. Objective: To examine the association between SHS exposure and childhood myopia. Design, Setting, and Participants: Cross-sectional data from the population-based Hong Kong Children Eye Study were used. Data were collected from March 5, 2015, to September 12, 2021, at The Chinese University of Hong Kong Eye Center. Participants included children aged 6 to 8 years. Secondhand smoke exposure was evaluated using a validated questionnaire. All participants underwent comprehensive ophthalmic and physical examinations. Exposure: Secondhand smoke exposure. Main Outcomes and Measures: Generalized estimating equations were constructed to examine the association of SHS exposure with spherical equivalent and axial length; logistic regression models, with myopia rate; and linear regression models, with myopia onset. Results: A total of 12 630 children (mean [SD] age, 7.37 [0.88] years; 53.2% boys) were included in the analysis. Among the participants, 4092 (32.4%) had SHS exposure. After adjusting for age, sex, parental myopia, body mass index, near-work time, outdoor time, and family income, SHS exposure was associated with greater myopic refraction (ß = -0.09 [95% CI, -0.14 to -0.03]) and longer axial length (ß = 0.05 [95% CI, 0.02-0.08]). Children with SHS exposure were more likely to develop moderate (odds ratio [OR], 1.30 [95% CI, 1.06-1.59]) and high myopia (OR, 2.64 [95% CI, 1.48-4.69]). The association of SHS exposure with spherical equivalence and axial length was magnified in younger children. For each younger year of a child's exposure to SHS, SHS exposure was associated with a 0.07-D decrease in spherical equivalence (ß = 0.07 [95% CI, 0.01-0.13]) and a 0.05-mm increase in axial length (ß = -0.05 [95% CI, -0.08 to -0.01]). Exposure to SHS was associated with an earlier mean (SD) age at onset of myopia (72.8 [0.9] vs 74.6 [0.6] months; P = .01). Every increase in SHS exposure in units of 10 cigarettes per day was associated with greater myopic refraction (ß = -0.07 [95% CI, -0.11 to -0.02]), axial length (ß = 0.04 [95% CI, 0.01-0.06]), and likelihood of developing moderate (OR, 1.23 [95% CI, 1.05-1.44]) and high myopia (OR, 1.75 [95% CI, 1.20-2.56]), and earlier myopia onset (ß = -1.30 [95% CI, -2.32 to -0.27]). Conclusions and Relevance: The findings of this cross-sectional study suggest that SHS exposure was associated with greater myopic refraction, longer axial length, greater likelihood of developing moderate and high myopia, and earlier myopia onset. The larger the quantity of SHS exposure and the younger the child, the more advanced myopia development and progression with which SHS exposure is associated.

IMI-Onset and Progression of Myopia in Young Adults.

Myopia typically starts and progresses during childhood, but onset and progression can occur during adulthood. The goals of this review are to summarize published data on myopia onset and progression in young adults, aged 18 to 40 years, to characterize myopia in this age group, to assess what is currently known, and to highlight the gaps in the current understanding. Specifically, the peer-reviewed literature was reviewed to: characterize the timeline and age of stabilization of juvenile-onset myopia; estimate the frequency of adult-onset myopia; evaluate the rate of myopia progression in adults, regardless of age of onset, both during the college years and later; describe the rate of axial elongation in myopic adults; identify risk factors for adult onset and progression; report myopia progression and axial elongation in adults who have undergone refractive surgery; and discuss myopia management and research study design. Adult-onset myopia is common, representing a third or more of all myopia in western populations, but less in East Asia, where onset during childhood is high. Clinically meaningful myopia progression continues in early adulthood and may average 1.00 diopters (D) between 20 and 30 years. Higher levels of myopia are associated with greater absolute risk of myopia-related ocular disease and visual impairment, and thus myopia in this age group requires ongoing management. Modalities established for myopia control in children would be options for adults, but it is difficult to predict their efficacy. The feasibility of studies of myopia control in adults is limited by the long duration required.

Corneal Electrolysis for Granular Corneal Dystrophy Type 2 (Avellino Corneal Dystrophy) Exacerbation After LASIK.

PURPOSE: To report two cases in which exacerbation of granular corneal dystrophy type 2 (GCD2; Avellino corneal dystrophy) after laser in situ keratomileusis (LASIK) was successfully removed by corneal electrolysis. METHODS: This study involved a 66-year-old man and a 43-year-old man with GCD2 who had undergone bilateral LASIK for myopia 10 or more years prior to presentation. In both patients, GCD2 corneal opacity gradually developed postoperatively at the LASIK flap interface, thus resulting in a decrease of visual acuity. For treatment, the LASIK flaps in both patients were surgically lifted to directly remove the opacity. Corneal electrolysis was then applied to the back of each LASIK flap and stromal bed. RESULTS: Postoperatively, the ocular symptoms and corneal opacities related to GCD exacerbation disappeared, with improvement of corrected and uncorrected distance visual acuity and almost no change of refractive error. CONCLUSIONS: The findings reveal that corneal electrolysis is safe and effective for treating exacerbations of GCD2 following LASIK when applied to a surgically lifted flap, and that it successfully removes GCD2-related LASIK flap interface opacities with almost no change of refractive error postoperatively. [J Refract Surg. 2023;39(1):61-65.].

The best choice for low and moderate myopia patients incapable for corneal refractive surgery: implantation of a posterior chamber phakic intraocular lens.

PURPOSE: This study aims to evaluate the early clinical outcomes of central hole phakic posterior chamber intraocular lens(ICLV4c) implantation for low and moderate myopia correction. METHODS: This retrospective clinical study included 27 patients(47 eyes)who underwent ICLV4c implantation to correct myopia with spherical equivalent (SE) between - 1.75D and -6.0D. The uncorrected visual acuity (UCVA), intraocular pressure(IOP), central anterior chamber depth (ACD), vault, and endothelial cell density (ECD) were evaluated after surgery. RESULTS: At one year follow-up, the postoperative UCVA of patients was higher than the preoperative CDVA and showed a stable trend. There was no significant difference in ECD (p > 0.05) one month after the surgery, the vault was 0.77 ± 0.32 mm, which decreased to 0.63 ± 0.26 mm after one year of surgery. Similarly, ACD was 3.24 ± 0.25 mm in the preoperative, which decreased significantly to 2.05 ± 0.39 mm at one month, while rose to 2.2 ± 0.39 mm at one year after surgery. There was no significant correlation between IOP and ACD and vault at one month and one year after surgery. The correlation coefficient between ACD and vault was found to be - 0.72 at one month after surgery, while the same -0.71 after one year. One patient developed visual fatigue, one with glare, and while no other complications were observed with the rest of the patients. CONCLUSION: The ICL implantation is a safe, effective and stable method to correct low and moderate myopia, and may be a good alternative for patients with low and moderate myopia who cannot undergo corneal refractive surgery.

Resultados sensoriales y motores en pacientes miopes tratados con técnicas de superficies / Sensory and Motor Outcomes in Myopic Patients Treated with Surface Techniques

Objetivo: Evaluar los resultados sensoriales y motores poscirugía refractiva con técnicas de superficie (LASEK-MMC o PRK-MMC) en pacientes miopes con o sin astigmatismo asociado. Método: Se realizó estudio experimental controlado aleatorizado abierto, en el cual fueron incluidos 160 pacientes (320 ojos), de ellos tratados con LASEK-MMC (80 pacientes) y con PRK-MMC (80 pacientes), seguidos por 3 meses. Las principales variables evaluadas fueron: edad, tipo de error refractivo, equivalente esférico, ángulo Kappa, anisometropía, estereopsis, punto próximo de convergencia y su anomalía, amplitud de convergencia y de divergencia (cerca y lejos) y magnitud de la desviación del alineamiento ocular. Resultados: El grupo tratado con PRK-MMC tenía edad media de 26,48 años ± 4,47 y equivalente esférico preoperatorio de -3,27 ±1,54 que disminuyó significativamente (p <0,05) a -0,04 ± 0,23 dioptrías (D) a los tres meses de la cirugía. El grupo tratado con LASEK-MMC tenía edad media de 26,31 años ± 4,86 y equivalente esférico preoperatorio de -3,34 ± 1,66 dioptrías (D) que disminuyó significativamente (p <0,05) a -0,06 ± 0,26 D a los tres meses de la cirugía. Además, disminuyó la anisometropía, mejoró la estereopsis y disminuyó la amplitud la amplitud de convergencia y divergencia para lejos. El alineamiento ocular también mejoró. Conclusiones: Las técnicas de superficies para tratar pacientes con miopía o astigmatismo miópico compuesto disminuyen la anisometropía, mejoran la estereopsis y disminuyen la amplitud de convergencia y divergencia para lejos, con mayor proporción de pacientes con ortoforia después de la operación(AU)

Purpose : To evaluate sensory and motor outcomes after refractive surgery with surface techniques (LASEK-MMC or PRK-MMC) in myopic patients with or without associated astigmatism. Methods : An open randomized controlled experimental study was performed, in which 160 patients (320 eyes) were included, treated with LASEK-MMC (80 patients) and with PRK-MMC (80 patients), followed up during 3 months. The main variables evaluated were: age, type of refractive error, spherical equivalent, Kappa angle, anisometropia, stereopsis, near convergence point and its anomaly, convergence and divergence amplitude (near and far) and magnitude of ocular alignment deviation. Results : The group treated with PRK-MMC had an average age of 26.48 years ± 4.47 and preoperative spherical equivalent of -3.27 ± 1.54 which decreased significantly (p < 0.05) to -0.04 ± 0.23 diopters (D) three months after surgery. The LASEK-MMC treated group had an average age of 26.31 years ± 4.86 and preoperative spherical equivalent of -3.34 ± 1.66 diopters (D) which decreased significantly (p < 0.05) to -0.06 ± 0.26 D three months after surgery. In addition, anisometropia decreased, stereopsis improved, Kappa angle increased, and convergence and divergence amplitude (for far) decreased; ocular alignment also improved. Conclusions : Surface techniques to treat patients with myopia or compound myopic astigmatism decrease anisometropia, improve stereopsis, increase Kappa angle, and decrease near point anomaly and convergence and divergence amplitude (for far), with higher proportion of patients with orthophoria postoperatively(AU)

Visual Outcomes of Photorefractive Keratectomy Enhancement After Primary LASIK.

PURPOSE: To evaluate the safety, efficacy, and predictability of photorefractive keratectomy (PRK) at least 4 years after primary laser in situ keratomileusis (LASIK) and compare it to the United States Food and Drug Administration (FDA) criteria. METHODS: This retrospective, single-site study compared patients who underwent PRK enhancement from 2014 to 2019 after primary LASIK to those who only underwent primary LASIK without re-treatment from the same time period. Patient demographics and clinical information were compared between the two groups. Visual outcomes and postoperative complications were evaluated in the enhancement group. RESULTS: A total of 374 eyes with PRK enhancement were compared to 472 without re-treatment. Age, sex, surgical eye, and preoperative sphere, and spherical equivalent (SE) were significantly different between the enhancement and control groups (P < .05). At 12 months post-enhancement, 67% had uncorrected distance visual acuity (UDVA) of 20/20 or better, 98% had UDVA of 20/40 or better, and 0.4% of eyes lost at least two lines of corrected distance visual acuity (CDVA). A total of 83% and 98% of eyes were within ±0.50 and ±1.00 diopters of the target, respectively. Post-enhancement complications (n = 66) included dryness (6.1%), epithelial ingrowth (2.7%), and haze (2.7%). CONCLUSIONS: Older age at the time of the primary LASIK, female sex, right surgical eye, and more myopic sphere and SE were risk factors for enhancement. Although PRK enhancements are considered off-label procedures, they produce favorable outcomes at 3 and 12 months postoperatively while meeting FDA benchmarks for safety, efficacy, and predictability. [J Refract Surg. 2022;38(11):733-740.].

Fallopia Japonica and Prunella vulgaris inhibit myopia progression by suppressing AKT and NFκB mediated inflammatory reactions.

BACKGROUND: The increased global incidence of myopia requires the establishment of therapeutic approaches. This study aimed to investigate the effect of Fallopia Japonica (FJ) and Prunella vulgaris (PV) extract on myopia caused by monocular form deprivation (MFD). METHODS: We used human retinal pigment epithelial cell to study the molecular mechanisms on how FJ extract (FJE) and PV extract (PVE) lowering the inflammation of the eye. The effect of FJE and PVE in MFD induced hamster model and explore the role of inflammation cytokines in myopia. RESULTS: FJE + PVE reduced IL-6, IL-8, and TNF-α expression in RPE cells. Furthermore, FJE and PVE inhibited inflammation by attenuating the phosphorylation of protein kinase B (AKT), and nuclear factor kappa-light-chain-enhancer of activated B (NF-κB) pathway. In addition, we report two resveratrol + ursolic acid compounds from FJ and PV and their inhibitory activities against IL-6, IL-8, and TNF-α expression levels in RPE cells treated with IL-6 and TNF-α. FJE, PVE, and FJE + PVE were applied to MFD hamsters and their axial length was measured after 21 days. The axial length showed statistically significant differences between phosphate-buffered saline- and FJE-, PVE-, and FJE + PVE-treated MFD eyes. FJE + PVE suppressed expressions of IL-6, IL-8, and TNF-α. They also inhibited myopia-related transforming growth factor-beta (TGF)-ß1, matrix metalloproteinase (MMP)-2, and NF-κB expression while increasing type I collagen expression. CONCLUSIONS: Overall, these results suggest that FJE + PVE may have a therapeutic effect on myopia and be used as a potential treatment option.

ANATOMIC AND TOPOGRAPHIC CHANGES OF ANTERIOR SEGMENT STRUCTURES IN EHLERS-DANLOS SYNDROME PATIENTS WITH MYOPIA.

OBJECTIVE: The aim: Determination of anatomical and topographical relationships of the eyeball anterior segment structures to assess possible glaucoma development risk factors in SED patients with myopic refraction. PATIENTS AND METHODS: Materials and methods: Patients, aged from 10 to 34, have been examined since 2009. All the patients have undergone required medic and genetic examination as well as generally accepted ophthalmological one. Ultrasound biomicroscopy (UBM) has been performed using the VuMax II apparatus (Sonomed, USA) with a sensor frequency of 50 MHz. RESULTS: Results: Biomicroscopy found no symptoms such as pigment dispersion on the iris stroma, in the chamber anterior angle, iris transillumination and "Krukenberg's Spindle", which are characteristic for the ultrasound picture in pigment dispersion syndrome. CONCLUSION: Conclusions: 1. Clinical and functional study with the eyeballs mandatory ultrasound biomicroscopy have revealed functional space limitations for the structures of the iridociliary zone in patients with myopic type of eye structure in SED. 2. Detected congenital changes in the anterior segment structures (iridociliary cystic formations and residual mesodermal tissue) can lead to the emergence of intraocular blocks. 3. The research has identified conducive anatomical and topographic changes, which are likely to induce pigment dispersion syndrome or lead to the development of pigmentary glaucoma. 4. In our opinion, the UBM role in the early diagnosing and monitoring patients with SED syndrome is quite significant in terms of assessing the stability or dynamics of the changes received and possible complications. Ultrasound biomicroscopic scanning should be added to the list of necessary early diagnostic examinations to determine the markers and features of structures in SED.

Horas pantallas y miopía en niños / Screen Hours and Myopia in Children

La masificación del Internet y comunicación móvil, así como el mayor acceso a herramientas digitales y de dispositivos electrónicos ha modificado la calidad de vida y salud de la población mundial, con un impacto especialmente importante en los niños. El uso desmedido de pantallas constituye un problema en esta población por su impacto en el sedentarismo, sobrepeso, alteraciones en el comportamiento, trastornos depresivos y del sueño, pero también por el efecto que tiene sobre el sistema visual en desarrollo: predispone a síndrome de ojo seco, a un exceso de acomodación-convergencia, provoca un desenfoque hipermetrópico de la fóvea (se cree que esto estimula el crecimiento axial), aumenta la tensión del cuerpo ciliar y músculos extraoculares, además de los efectos nocivos de la luz azul-violeta para las estructuras intraoculares. Estudios sugieren que los niños son más propensos a desarrollar miopía por estar menos expuestos a la luz natural y pasar más tiempo en ambientes cerrados ante pantallas, muchos incluso han demostrado una asociación entre el uso de pantallas, el trabajo cercano y la presencia de miopía, pero no existen datos concluyentes que aíslen un riesgo independiente. A partir de esta revisión se concluye que la prevalencia de la miopía está aumentando con base en una etiología multifactorial(AU)

The massification of the Internet and mobile communication, as well as increased access to digital tools and electronic devices, have changed the quality of life and health of the world's population, with a particularly important impact on children. The excessive use of screens is a problem among this population because of its impact on sedentary lifestyles, overweight, behavioral alterations, depressive and sleep disorders; but also because of its effect on the developing visual system, since it predisposes to dry eye syndrome, excessive accommodation-convergence, causes hypermetropic defocus at the fovea (this is believed to stimulate axial growth), increases the tension of the ciliary body and extraocular muscles, in addition to the harmful effects of blue-violet light on intraocular structures. Studies suggest that children are more prone to developing myopia because they are less exposed to natural light and spend more time in indoor environments in front of screens; many studies have even shown an association between the use of screens, close-eye work and the presence of myopia, but there are no conclusive data that isolate an independent risk. From this review, the prevalence of myopia is concluded to be increasing based on a multifactorial etiology(AU)

Changes in visual outcomes and ocular morphometrics after foldable myopic and toric intraocular lens implantation: 5-year results.

PURPOSE: To evaluate the refractive, visual, and morphometric changes after implantation with a foldable iris-fixated phakic intraocular lens (pIOL) to correct myopia or astigmatism. SETTING: University Eye Clinic Maastricht, the Netherlands. DESIGN: Prospective case series. METHODS: We evaluated patients implanted with the Artiflex Myopia Toric (Ophtec B.V.) iris-fixated pIOL as of January 2004. Measurements were performed annually and reported after 1 and 5 years. RESULTS: The study included 481 eyes (277 patients; age 39.8 ± 10.9 years [SD]). 5 years postoperatively, 91% of eyes were within ±1.0 diopter (D) of target, and the mean myopization over a 5-year period was 0.22 D (P < .001). The logMAR corrected distance visual acuity (CDVA) increased by a mean 0.015 (P = .015) over 5 years; 88% of eyes had a CDVA of 20/20 or better, and 5.5% lost 2 or more lines of CDVA. Mean uncorrected distance visual acuity (UDVA) increased by 0.045 logMAR over 5 years (P < .001); 96% reached an UDVA of 20/40 or more. Anterior chamber depth (ACD) decreased by 0.04 mm (P < .001), and axial length (AL) increased by 0.23 mm (P < .001) over 5 years. Chronic endothelial cell loss showed a 5-year decline of 320 cells/mm2 in the myopic and 310 cells/mm2 in the toric subgroups (P < .001). Cataract resulted in pIOL explantation in 4.0% of eyes (mean survival 59.0 ± 40.0 months); higher preoperative age (hazard ratio [HR], 1.13; P < .001) and smaller ACD (HR, 6.80; P = .035) were risk factors for shorter survival due to cataract formation. CONCLUSIONS: Over 5 years, logMAR CDVA and UDVA decreased significantly due to myopization caused by lenticular changes and AL elongation.

Refractive errors and risk factors for myopia in infants aged 1-18 months in Tianjin, China.

BACKGROUND: Infancy is the of a child's visual development. Refractive errors, especially myopia, are a common vision disorder. Thus, the purpose of this study was to explore refractive errors and risk factors for myopia among infants aged 1-18 months in Tianjin, China. METHODS: A total of 583 infants aged 1-18 months participated in this cross-sectional study at Tianjin Women's and Children's Health Center in China from February 2019 to November 2020. Each infant received a complete ophthalmologic examination, and myopia-related risk factors were investigated using a questionnaire. RESULTS: A total of 583 eligible infants participated in this study, including 312 (53.5%) boys and 271 (46.5%) girls. There were 164 (28.1%) premature born infants. The mean age was 6.59 ± 4.84 months (range, 1-18 months). The mean spherical equivalent (MSE) for the right eye was 1.81 D ± 1.56 D, with no difference related to sex (P = 0.104). Refractive state showed an average hyperopia of +2.74 ± 1.74 D at early ages, followed by a trend toward less hyperopia, finally reaching +1.35 ± 1.44 D at the age of 18 months (P ≤0.001). The overall prevalence rates of myopia (MSE ≤ -0.50 D), emmetropia (-0.50 D