Bromfenac sodium 0.1%, fluorometholone 0.1% and dexamethasone 0.1% for control of ocular inflammation and prevention of cystoid macular edema after phacoemulsification.

PURPOSE: To compare bromfenac sodium 0.1%, fluorometholone 0.1% and dexamethasone 0.1% for the control of postoperative inflammation and prevention of cystoid macular edema (CME) after phacoemulsification. METHODS: Patients were randomized to receive bromfenac sodium 0.1% for 1 month (OBS1) or 2 months (OBS2), or fluorometholone 0.1% for 1 month (OFM) or dexamethasone 0.1% for 1 month (ODM). Best-corrected visual acuity, intraocular pressure, endothelial cell density, photon count value and retinal foveal thickness were measured. RESULTS: Mean photon count values were lower in the OBS1 and OBS2 groups compared with the ODM group during the first week. Bromfenac sodium cleared the ocular inflammation more rapidly than fluorometholone and dexamethasone. The foveal thickness was thinner in the second month and the incidence of CME was lower in the OBS1 and OBS2 groups compared with the OFM and ODM groups. CONCLUSION: Bromfenac sodium was more effective and safer than fluorometholone and dexamethasone as an anti-inflammatory, decreasing macular thickness and preventing CME in age-related cataract patients after cataract surgery.

[Recent advances in femtosecond laser-assisted cataract surgery].

As the leading cause of blindness, the type of surgery performed to remove cataracts has evolved from Intracapsular to Extracapsular and to phacoemulsification. Advantages of femtosecond laser include high instantaneous power, strong penetration, short pulse-duration and micro-precision present superior accuracy, predictability and safety to cataract surgery, while also minimizing injury to surrounding ocular tissue. It mainly assists in the procedures of anterior capsulotomy, lens fragmentation, clear corneal incision and limbal relaxing incision creation. However, compared to conventional phacoemulsification, problems such as the minimization of complications and difficulties in conducting peer-reviewed studies with a longer follow-up period and large sample, as well as coverage of added costs remain untracked.The purpose of this review is to outline the advantages and disadvantages as well as clinical value of this evolving technology compared to conventional phacoemulsification.

Comparative clinical outcomes of Tecnis toric IOL implantation in femtosecond laser-assisted cataract surgery and conventional phacoemulsification surgery.

AIM: To compare the short-term visual outcomes, residual refractive cylinder, and rotation stability after Tecnis toric intraocular lens (IOL) implantation during femtosecond laser-assisted cataract surgery (Femto phaco) and conventional phacoemulsification surgery (Conventional phaco). METHODS: In a prospective cohort study, Conventional phaco and Femto phaco (anterior capsulotomy and lens fragmentation by a femtosecond laser) with Tecnis toric IOL implantation were performed in 40 eyes from 36 patients and 37 eyes from 33 patients, respectively. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and manifest refraction were assessed during 1d, 1wk, and 1mo follow-ups. The orientation of the Tecnis Toric IOL was evaluated during 1wk and 1mo follow-ups. RESULTS: There were no significant differences in UDCA or CDVA between two groups at 1mo postoperatively, though relatively more subjects had UDVA values of 20/25 or better in Femto phaco group than in the Conventional group (P>0.05). A lower but not significantly lower rate of having more than 5° of IOL rotation was observed in Femto phaco group at the 1-month follow-up, while a significant lower rate of residual astigmatism of ≤1 D was observed in Femto phaco group. CONCLUSION: The Femto phaco group has significantly more subjects with the residual astigmatism of ≤1 D, but there are no significant differences in rotation stability and visual outcomes as compared with the Conventional phaco group after the application of the Tecnis toric IOL in this cohort.

A novel splice site mutation of CRYBA3/A1 gene associated with congenital cataract in a Chinese family.

AIM: To identify the disease-causing mutation responsible for the presence of congenital cataract in a Chinese family. METHODS: The study recruited a four-generation Chinese pedigree affected by autosomal dominant congenital cataract (ADCC). Family history and the history of cataract extraction were recorded. Blood samples were collected from individuals for DNA extraction. Direct sequencing of congenital cataract-associated genes was performed. Single-strand conformational polymorphism and bioinformatic analysis were conducted to further study the mutation. RESULTS: Direct sequencing revealed a novel splice site mutation of c.30-2 A>G in the CRYBA3/A1 gene. The mutation co-segregated within all affected individuals in the family and was not found in unaffected members or 100 unrelated normal controls. These results were further confirmed by single-strand conformational polymorphism and bioinformatic analysis using the Human Splicing Finder and MaxEnt online software and Annovar computer software. CONCLUSION: c.30-2 A>G mutation of CRYBA3/A1 gene is a novel mutation and broadens the genetic spectrum of ADCC.

A comparable study of clinical and optical outcomes after 1.8, 2.0 mm microcoaxial and 3.0 mm coaxial cataract surgery.

AIM: To evaluate the clinical and optical outcomes after clear corneal incision cataract surgery (CICS) with three different incision sizes (1.8, 2.0 and 3.0 mm). METHODS: Eyes of 150 patients with age-related cataract scheduled for coaxial cataract surgery were randomized to three groups: 1.8, 2.0, or 3.0 mm CICS. Intraoperative data and postoperative outcomes including surgically induced astigmatism (SIA), the corneal incision thickness, wavefront aberrations and modulation transfer function (MTF) of cornea were obtained. RESULTS: There were no significant differences among the three groups in demographic characteristics and intraoperative outcome. The 1.8 and 2.0 mm microincisions showed more satisfactory clinical outcomes than the 3.0 mm incision. The 1.8 mm incision showed significantly less SIA than the 2.0 mm incision until postoperative 1mo (P<0.05), but the difference was only 0.14-0.18 D. Combined with less increased incision thickness only at postoperative 1d (P=0.013), the 1.8 mm incision presented better uncorrected distance visual acuity (UCDVA) than the 2.0 mm incision only at 1d postoperatively (P=0.008). For higher-order aberrations and other Zernike coefficients, there were no significant differences between the 1.8 mm group and 2.0 mm group (P>0.05). CONCLUSION: Converting from 3.0 mm CICS to 1.8 or 2.0 mm CICS result in better clinical and optical outcomes. However, when incision is 1.8 mm, the benefits from further reduction in size compared with 2.0 mm are limited. The necessity to reduce the incision size is to be deliberated.

A novel FBN1 missense mutation (p.C102Y) associated with ectopia lentis syndrome in a Chinese family.

AIM: To characterize the disease-causing mutations in a Chinese family with ectopia lentis syndrome (ELS). METHODS: Patients and their family members were given complete physical, ophthalmic, and cardiovascular examinations. Genomic DNA samples were extracted from the peripheral blood of the pedigree members and 100 healthy controls. Mutation screening was performed in the fibrillin-1 (FBN1) gene by bi-directional sequencing of the amplified products. The mutation was analyzed using two bioinformatics methods. RESULTS: A novel heterozygous c.305G>A mutation in exon 3 of FBN1 was detected. As a result of this change, a highly conserved cysteine residue was replaced by a tyrosine residue (p.C102Y). Another mutation was found in the same exon (c.303T>C), which did not change the amino acid sequence. Both mutations were discovered in each affected individual, but not in the unaffected family members, or in 100 ethnically matched controls. A bioinformatics analysis predicted that mutation p.C102Y would affect protein function. CONCLUSION: In the first epidermal growth factor-like module, we identified a novel FBN1 mutation (p.C102Y), which caused ELS in the family. Our study presented a unique phenotype, including some distinct ophthalmic findings, such as hypoplasia of the iris and anisometropia. Our results expanded the mutation spectrum of FBN1 and enriched the overall knowledge of genotype-phenotype correlations due to FBN1 mutations.