Study on the enlargement index of femtosecond laser-assisted capsulorhexis in 2-6-year-old patients with congenital cataract.

BACKGROUND: To identify the capsule enlargement index after femtosecond laser-assisted anterior capsulorhexis in 2-6-year-old children who underwent congenital cataract surgery. METHODS: In this prospective case series study, femtosecond laser-assisted anterior capsulorhexis was performed in patients with congenital cataract, aged 2-6 years. The actual achieved capsulorhexis diameters were measured with Digimizer version 4.2.6. Correlation coefficient (r) and multiple linear regression analysis were used to evaluate the variables that could potentially influence anterior capsulorhexis enlargement index (E). RESULTS: This prospective study enrolled 28 eyes of 22 patients with congenital cataract. The mean age of the patients at surgery was 4.67 years ±1.54 (standard deviation [SD]). "E" of the 28 cases was 1.211 ± 0.039 (SD). Correlation analysis showed that "E" correlated significantly with the anterior chamber depth (ACD) (r = - 0.469, p = 0.021) and axial length (AL) (r = 0.452, p = 0.027). The following formula was developed by using multivariable linear regression analysis: Predicted E = 1.177-0.052 × ACD + 0.009 × AL, R2 = 0.346 (F = 4.396, p = 0.046). CONCLUSIONS: The anterior capsulorhexis enlargement index and its calculation formula could help to set up an accurate programmed capsulorhexis diameter for femtosecond laser-assisted congenital cataract surgery in children aged 2-6 years. Thus, an appropriate actual capsulorhexis diameter could be achieved.

Prevalence of reduced visual acuity among school-aged children and adolescents in 6 districts of Changsha city: a population-based survey.

BACKGROUND: To calculate and evaluate the prevalence of reduced uncorrected distant visual acuity (UCDVA) in primary, middle and high schools in 6 districts of Changsha, Hunan, China. METHODS: A population-based retrospective study was conducted in 239 schools in 6 districts of Changsha. After routine eye examination to rule out diseases that can affect refraction, 250,980 eligible students from primary, middle and high schools were enrolled in the survey. Then the uncorrected distant and near visual acuity of each eye were measured. Categories of schools, districts, grades, eye exercises and sports time were also documented and analyzed. RESULTS: The overall prevalence of reduced UCDVA was 51.8% (95% confidence interval [CI]: 51.6-52.0%) in 6 districts of Changsha. Results of individual districts were as follows: Furong district 59.9%(95% CI: 57.9-61.8%), Tianxin district 62.3%(95% CI: 60.5-64.0%), Wangcheng district 47.8%(95% CI: 46.8-48.8%), Kaifu district 58.5%(95% CI: 58.0-58.9%), Yuhua district 47.0%(95% CI: 46.7-47.4%) and Yuelu district 52.6%(95% CI: 52.3-52.9%). The proportion of normal VA is seen to decrease from primary grade 3. The proportion of mildly reduced UCDVA is higher in primary grade 1 and 2. The proportion of moderately reduced UCDVA remains similar during 12 grades. The proportion of severely reduced UCDVA increases with grades. Multivariate analysis shows that the prevalence of reduced UCDVA is higher in key schools (risk ratio [RR] = 1.47, 95% CI 1.44-1.50) than non-key schools. CONCLUSIONS: According to the existing data analysis results, the prevalence of reduced UCDVA among primary, middle and high school students in Changsha is very high. Some effective measures need to be taken to prevent it.

Parameters influencing the effectiveness of femtosecond laser-assisted capsulotomy in white cataract surgery.

Purpose: To explore the parameters that may influence the effectiveness of femtosecond laser-assisted capsulotomy in white cataract surgery and its cutoff points. Design: A retrospective case series. Methods: This retrospective case series study enrolled patients with white cataract who had undergone surgery at Changsha Aier Eye Hospital from July 2018 to January 2020. All patients underwent femtosecond laser-assisted capsulotomy using a contact femtosecond laser device (LenSx, Alcon Laboratories, USA). The sex, age, corrected distance visual acuity (CDVA), intraocular pressure (IOP), axial length (AL), lens thickness (LT), anterior chamber depth (ACD) and mean keratometry (Km) were recorded. All eyes were divided into successful capsulotomy group and unsuccessful capsulotomy group according to the capsulotomy integrity. Both groups were compared and two-sample t-test was used in order to find the optimal cutoff points of the parameters. Results: 60 eyes of 59 patients were included in the study. A successful capsulotomy was achieved in 36 eyes (60 %), while unsuccessful capsulotomy occurred in 24 eyes (40 %). Although no significant differences were observed in sex (P = 0.704), AL (P = 0.598) and Km (P = 0.873) between both groups, LT (P < 0.01), ACD (P = 0.014) and age (P < 0.01) were significantly different; a LT of 5.21 mm was found to be the optimal cutoff point. Conclusions: Femtosecond laser-assisted capsulotomy in white cataract is safe and effective. LT, ACD and age may influence the effectiveness of femtosecond laser-assisted capsulotomy in patients with white cataracts. LT is the main associated parameter and 5.21 mm is the optimal cutoff point for LT.

Ocular Dominance Shift in Refractive Cataract Surgery: A prospective, observational study.

PURPOSE: To explore the features of the dominant and non-dominant eyes in patients with cataracts and predict ocular dominance shift (ODS) based on preoperative indicators. DESIGN: and setting: This prospective, observational study was conducted in Changsha Aier Eye Hospital in Changsha, Hunan province, China. METHODS: Patients with age-related cataracts who underwent unilateral cataract surgery were enrolled in this study. Before the procedure, uncorrected visual acuity (UCVA) was assessed, and non-cycloplegic subjective refraction evaluations were conducted to determine best-corrected visual acuity (BCVA). Total astigmatism, corneal astigmatism, and intraocular astigmatism were measured using OPD-Scan III. Cataract type was assessed using slit-lamp biomicroscopy based on the Lens Opacities Classification System III (LOCS III). Ocular dominance (OD) was determined under corrected conditions using the hole-in-card test. Follow-up visits occurred at 1 day, 1 week, and 1-month post-surgery. After 1 month, OD was re-evaluated, and participants completed the Catquest-9SF questionnaire. RESULTS: 94 patients (188 eyes) were enrolled in the study. The analysis showed that the ODS rate of unilateral cataract surgery was 40.4%. In addition, age, uncorrected visual acuity of non-dominant eye, posterior subcapsular cataract and total astigmatism are risk factors for ODS. Besides, no difference in vision-related quality of life was detected between patients who had ODS and those who did not. CONCLUSIONS: We identified several preoperative parameters as potential risk factors of ODS after cataract surgery. These findings provide guidance for predicting changes in the dominant eye, thus improve the precise selection of intraocular lenses and the implementation of monovision strategies.