The Effects of Implantable Collamer Lens ICL Implantation in High Myopia Patients' Mental Health.

Purpose: To investigate the psychological changes in patients pre and post implantable collamer lens (ICL, EVO) implantation surgery in the posterior chamber. Patients and methods: Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the mental states of 43 patients who underwent ICL implantation surgery performed by the same surgeon between January 2021 and December 2022. Results: Comparing the results before and one week after the operation, there is a significant difference in both the SAS scale (P<0.05) and the SDS scale (P<0.05). Similarly, when comparing the pre-operation and one-month post-operation results, there is also a significant difference in both the SAS scale (P<0.05) and the SDS scale (P<0.05). However, when comparing the one-week post-operation and one-month post-operation results, there is no significant difference in either the SAS scale (P>0.05) or the SDS scale (P>0.05). Moving on to the comparison between the pre-operation results and the national norm level, there is a significant difference in both the SAS scale (P<0.05) and the SDS scale (P<0.05). When comparing the one-week post-operation results and the national norm level, there is a significant difference in the SAS scale (P<0.05). Similarly, when comparing the one-month post-operation results and the national norm level, there is a significant difference in the SAS scale (P<0.05). Conclusion: After undergoing ICL implantation surgery, patients typically experience a notable decrease in anxiety (SAS) and depression (SDS) scales. These improvements gradually stabilize and enhance during the postoperative recovery period. However, it may require a significant amount of time for patients to fully restore their psychological well-being to levels comparable to the national norm, particularly in terms of anxiety levels.

Efficacy and safety of high-intensity focused ultrasound cyclo-plasty in glaucoma.

BACKGROUND: High-intensity focused ultrasound cyclo-plasty (UCP) is a recently developed glaucoma surgery. This study collected and analysed the clinical data of patients who underwent UCP to observe the efficacy and safety of this surgery in Chinese glaucoma patients. METHODS: This was a retrospective study. The clinical data of all the patients who underwent UCP at Affiliated Foshan Hospital, Southern Medical University, were collected and analysed to evaluate the efficacy and safety of UCP. The main outcome measure was intraocular pressure, and the secondary outcome measures were best corrected visual acuity (logMAR) and complications. RESULTS: Fifty-eight patients (61 eyes) were recruited for this study. IOP was dramatically decreased during the 12 months after UCP (p<0.05). The median IOP reduction during the 18 months post-procedure was more than 30%. The greatest reduction was at 1 month post-UCP (60.86%). The qualified success rate was more than 60% during the 18-month follow-up (Fig. 1). Poor follow up was found after 6-month post-UCP. The highest success rate was obtained at 7 days post-UCP (94.55%). No statistically significant decrease in BCVA in the vison group was observed at the follow-up visits, except for 1 day post-UCP. There was a statistically significant reduction in the use of IOP lowering medications during the 6 months post-UCP. No severe complications occurred. CONCLUSION: UCP is a safe and effective procedure for primary and refractive glaucoma at least during the 6 months post-UCP procedure. Studies with longer follow-up time and better follow up are needed to further confirm the long-term efficacy and safety of UCP in Chinese glaucoma patients.

Evaluation of macular microvascular density using optical coherence tomography angiography in patients with Posner-Schlossman syndrome.

BACKGROUND: Optical coherence tomography angiography (OCTA) is a novel technology that provides a noninvasive, dye-less method to visualize the blood vessels of the retina. In the present study, we investigate macular microvascular density and the correlation of ocular and demographic factors using OCTA in Posner-Schlossman syndrome (PSS) patients. METHODS: This is a prospective observational study. All PSS patients and age- and sex-matched healthy subjects underwent complete ophthalmologic examination, and RE, BCVA, IOP, CCT, AL, CMT, GCIPI, RNFL, C/D ratio were recorded. The whole-image vessel density (wiVD) and whole-image perfusion density (wiPD), three-circle (1 mm central ring, 3 mm inner ring, 6 mm outer ring), and four-quadrant segmental VD and PD were calculated. RESULTS: Seventeen PSS patients and 17 healthy subjects were enrolled in this study. The mean age was 42.65 ± 11.22 years in PSS patients and 42.71 ± 10.50 years in healthy controls. IOP, CCT, and C/D ratio were higher in PSS-attacked eyes, and BCVA, OPP and RNFL thickness was lower than those in the fellow eyes (p < 0.05). BCVA and OPP were improved in the PSS-attacked eyes in intermittent period (p < 0.05). The wiVD and wiPD were lower in the PSS-affected eyes than in the fellow eyes and in the control eyes in the PSS-attacked period (p < 0.05). All segmental VD and PD was lower in the PSS affected eyes than in the healthy control eyes (p < 0.05). In intermittent period, the wiVD and wiPD were lower in the PSS-affected eyes than in the fellow eyes (p < 0.05). Age, CCT, and SSI were associated with macular wiVD and wiPD in PSS attacked period. Age and CCT were associated with macular wiVD and wiPD in PSS intermittent period. CONCLUSION: Decreased macular superficial VD and PD was found in patients with Posner-Schlossman syndrome in attacked period and in remission. Macular wiVD and wiPD were associated with age, CCT and SSI in PSS patients.

Factors for Visual Acuity Improvement After Anti-VEGF Treatment of Wet Age-Related Macular Degeneration in China: 12 Months Follow up.

Purpose: To evaluate the treatment solutions and effectiveness of intravitreal ranibizumab (RBZ) or conbercept in patients with wet age-related macular degeneration (wAMD) in a real-life setting in China. Methods: The medical records of 368 patients with wAMD who started RBZ or conbercept treatment between 1 May 2014 and 30 April 2018 were evaluated. All patients were defined on fundus angiography at baseline to determine the subtype of AMD (PCV or CNV). We report visual acuity (VA) and central retinal thickness (CRT) measurements at baseline and 12 months. Results: The average number of anti-VEGF injections was 2.1 ± 1.2. The BCVA improvement of these two groups was similar with a difference of 1.00 letter (95% CI: -1.4~3.4, p = 0.8505). At the end of the study, a BCVA increase of at least 5 letters was determined to be a satisfactory efficacy endpoint. Several factors were related to the possible improvement in the satisfactory efficacy endpoint, including female sex (OR 2.07, 95% CI 1.22~3.51), number of injections (OR 1.40, 95% CI 1.12~1.75) and VA change at the first month (OR 13.75, 95% CI 7.41~25.51). Additionally, some factors were related to the possible reduction in the satisfactory efficacy endpoint, including diabetes (OR 0.27, 95% CI 0.10~0.73) and disease history (OR 0.75, 95% CI 0.57~0.98). Conclusion: Our study demonstrates that anti-VEGF drugs can effectively improve BCVA and reduce CRT in AMD patients. Sex, number of injections, VA change at the first month, diabetes and disease history are the most important factors affecting visual acuity.

EDI-OCT choroidal thickness in Posner-Schlossman syndrome.

PURPOSE: To compare the choroidal thickness (CT) of the affected eyes with the contralateral eyes in the active period and in the remission period in Posner-Schlossman syndrome (PSS) using EDI-OCT. PATIENTS AND METHODS: This prospective longitudinal study included 15 patients with PSS and 15 age- and sex-matched healthy subjects. All subjects underwent complete ophthalmologic examinations, and EDI-OCT was conducted to measure macular CT (mCT) at the subfoveal locations and at 0.5, 1.0 and 2.0 mm superior, inferior, nasal and temporal to the fovea. The mean measurements at each location were used for analysis. Linear regression analysis was performed to analyse the correlation between the choroidal thickness and IOP, and the correlation between the choroidal thickness and episode time. RESULTS: The mean mCT was significantly thinner in affected eyes than in contralateral eyes in the acute phase (p = 0.010) but were not different in the remission phase (p = 0.404). The mean mCT was significantly increased in the remission phase compared to that in the acute phase in the affected eyes (p = 0.000). The mCT of healthy subjects was significantly thicker than in the affected eyes (p = 0.020) and similar to the fellow eyes of PSS patients (p = 0.357) in the acute phase. Linear regression analyses show negative correlations between the mCT changes and IOP changes in the affected eyes compared to those in the fellow eyes in the acute period (R2 = 0.396, p = 0.033) and between the mCT changes and IOP changes from the acute period to the remission period in the affected eyes (R2 = 0.372, p = 0.027). Linear regression analyses show positive correlations (age- and sex-matched) between the CT changes and episode time from the affected eyes to the fellow eyes in the acute period (R2 = 0.492, p = 0.012). CONCLUSIONS: The mCT values of the PSS-affected eyes were significantly thinner than those of the fellow eyes in the acute phase and in the remission phase, and this change was correlated with IOP reduction and episode time.

Comparison of the mydriatic effects of mydrin-P and compound tropicamide in the screening of retinopathy of prematurity.

PURPOSE: To observe and compare the effects of pupil dilation between Mydrin-P and compound tropicamide in the screening of retinopathy of prematurity. METHODS: The right eyes of premature infants received My- drin-P eye drops as the treatment group, whereas the left eyes were administered with compound tropicamide as the control group. The eye drops were delivered every 5 min for three times. The pupil size was observed and recorded at 10, 15, and 20 min after administering mydriasis. RESULTS: The mean pupil diameter did not significantly differ between the treatment and control groups at 10 (6.24 ± 0.72 mm vs. 6.24 ± 0.68 mm, t = 0.00, P = 1.00), 15 (6.83 ± 0.55 mm vs. 6.78 ± 0.54 mm, t = 1.75, P = 0.083) or 20 min (7.22 ± 0.40 mm vs. 7.15 ± 0.50 mm, t = 1.62, P = 0.109), respectively. How- ever, the mean pupil size at any two time points significantly differed in both groups (all P < 0.001). CONCLUSION: Both Mydrin-P and compound tropicamide exert similar clinical efficacy in the screening of retinopathy of pre- maturity. The most appropriate time for screening was at 20 min after mydriasis.

Stereopsis after implantation of intraocular lens in patients under 40 years old with unilateral cataract.

PURPOSE: To investigate the stereopsis after single focus intraocular lens (SIOL) implantation in patients aged <40 years with unilateral cataract. METHODS: In total, 36 patients (36 eyes) were divided into emmetropia and myopia groups. Twenty seven subjects with good uncorrected distance visual acuity (UCDVA) after surgery were enrolled in the emmetropia group. The myopia group consisted of 9 subjects whose one eye had mild myopia postoperatively and the other was emmetropic or myopic. Visual acuity, distance and near stereoacuity were measured post-operatively. RESULTS: In the emmetropia group, uncorrected near visual acuity (UCNVA) did not differ significantly between eyes (t=1.87, P>0.05). The LogMAR UCNVA of the operated and fellow eyes were (0.71±0.12) and (-0.05±0.07, t = 28.4, P<0.001) respectively. Distance stereoacuity was 60"; the near stereoacuity with uncorrected visual acuity and BCNVA in the operated eyes were 200" and 30" respectively (Z=－4.121, P<0.001). In the myopia group, the BCDVA did not differ significantly between the operated and fellow eyes (t =-0.636, P>0.05). The UCNVA of the operated eyes (0.18±0.12) was significantly better compared with that of the fellow eyes (-0.04±0.10, t = 4.2252, P<0.001). The distance stereoacuity with uncorrected visual acuity and BCDVA in the operated eyes were 200" and 60" respectively (Z =-2.371, P<0.05). The near stereoacuity with uncorrected visual acuity was 50". CONCLUSION: For patients with unilateral cataract aged <40 years, stereopsis is closely associated with refractive status after IOL implantation. Near stereoacuity in emmetropic eyes can be improved with refraction, and that in mildly myopic eyes can be enhanced by leaving myopia uncorrected.

[The observation of visual quality after the implantation of apodized diffractive multifocal intraocular lens].

OBJECTIVE: To obverse visual acuity, visual symptom and the rate of spectacle independence after implantation of a multifocal intraocular lens (MIOL) in patients with age related cataract. METHODS: Sixty patients (68 eyes) with age-related cataract were enrolled in two groups. ReSTOR SA60D3 MIOL and Natural SN60AT monofocal intraocular lens were specially implanted after phacoemulsification. Uncorrected distance visual acuity (UCDVA), best-corrected distance visual acuity (BCDVA), uncorrected near visual acuity (UCNVA), best-corrected near visual acuity (BCNVA), distance-corrected near vision acuity (DCNVA), visual symptom and the rate of spectacle independence were observed. RESULTS: UCDVA and BCDVA in multifocal group were not statistically different from those in monofocal group (P > 0.05). UCNVA and DCNVA were statistically better in multifocal group than in monofocal group (P < 0.05). The multifocal group has higher rate of spectacle independence than the monofocal group (73.3% versus 13.3%) (P < 0.05) when reading. The visual symptom such as glare and halo were more serious in multifocal group than in monofocal group (P < 0.05). CONCLUSIONS: Acrysof ReSTOR apodized diffractive multifocal intraocular lens may provide an excellent distance and near visual acuity, and decrease the dependence of spectacle.

[Clinical investigation of iris-claw phakic intraocular lens implantation for high myopia].

OBJECTIVE: To investigate the efficacy and safety of an iris-claw phakic intraocular lens (ICPIOL) implantation for high myopia. METHODS: A consecutive group of 25 eyes in 13 patients with -7.88 to -22.88 diopters (D) of myopia was implanted with the Verisyse ICPIOL (AMO), and was examined preoperatively and 1, 7 days, 1, 3, 6, and 12 months postoperatively. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, intraocular pressure, and complications were evaluated. RESULTS: The implantation was successful in all of 25 eyes. Compared with preoperative data, UCVA, BCVA, and spherical equivalent (SE) were improved significantly. At 12-month postoperatively, UCVA was 0.5 or better in all eyes, in which the UCVA in 71.43% eyes was 0.8 or higher; No loss of BCVA was found, 2 lines of BCVA improvement was obtained in 95.24% of patients with ICPIOL, and 1 line BCVA improvement was seen in 4.76% of patients; the power of refraction in all eyes implanted with ICPIOL was stabilized within the variation of +/- 0.50D (71.43%), and +/- 1.00D (85.71%). The corneal endothelial loss was insignificant. No severe complications occurred. CONCLUSIONS: At short-term follow-up, the implantation of the ICPIOL proved to be safe and effective for the correction of myopia in phakic eyes. However, longer follow-up with larger numbers of patients is necessary to evaluate long-term complications.

[The clinical investigation of early visual function in cataract patients after implantation with aspheric intraocular lens].

PURPOSE: To initially evaluate the early visual function after implantation with aspheric intraocular lens METHODS: Eighty-eight subjects (91 eyes) were divided randomly into three groups: AcrySof IQ (SN60WF) group, KS-3Ai group and AcrySof Natural (SN60AT) group. Best corrected visual acuity was observed 1 day, 1 week and 1 month postoperatively, while contrast sensitivity and subjective vision were observed 1 month later. RESULTS: Best corrected visual acuity was obviously better in KS-3Ai group than in the other groups 1 day postoperatively (P < 0.05), but no significant difference was found 1 week and 1 month later among the groups (P > 0.05). When the pupil diameter was in 2.5 to 4.0 mm and 5.0 to 6.0 mm, AcrySof IQ and KS-3Ai groups were better than the AcrySof Natural group in the low and middle spatial frequency (P < 0.05). However, there was no significant difference between AcrySof IQ and KS-3Ai groups (P > 0.05). VF/QOL questionnaire was obtained, showing that implantation with AcrySof IQ and KS-3Ai satisfied patients preferably. CONCLUSIONS: Aspheric intraocular lens can greatly improve patients' contrast sensitivity and quality of vision.

[The clinical study of stereopsis after bilateral intraocular lens implantation].

PURPOSE: To observe the stereopsis of senile cataract patients after bilateral intraocular lens (IOL) implantation. METHOD: Subjects were divided into two groups: IOL group and normal group. Near stereoacuity with distance and near correction was checked with Randot steretests respectively. Near vision acuity was recorded with Logmar. RESULT: Near stereoacuity with distance correction was (101 +/- 59)" and (112 +/- 55)" respectively, the responding near vision acuity was 0.51 +/- 0.15 and 0.52 +/- 0.17. Near stereoacuity with near correction was (33 +/- 11)" and (34 +/- l0)", the responding near vision acuity was 0.09 +/- 0.10 and 0.11 +/- 0.11. There was no significant difference in near stereoauity and near vision acuity between two groups (P > 0.05). Stereoauity and near vision acuity with near correction was significantly improved in both groups (P < 0.01). CONCLUSION: Stereopsis after bilateral intraocular lens implantation was improved.

Ultrasound biomicroscopy of iris-claw phakic intraocular lens implantation.

PURPOSE: To study in situ the intraocular position of iris-claw phakic intraocular lens (ICPIOL) in myopic eyes using ultrasound biomicroscopy (UBM). METHODS: UBM echograms of the anterior segment were taken preoperatively and 62 to 115 days postoperatively in 6 eyes implanted with the Verisys ICPIOL (AMO). The echograms were assessed for the effect of the ICPIOL on iris tissue. RESULTS: The preoperative distance between the corneal endothelium and the lens ranged from 2.96 to 3.09 mm, and the postoperative distance between the ICPIOL and the corneal endothelium, from 1.86 to 2.03 mm. The distance between the lens and the posterior surface of the ICPIOL ranged from 0.61 to 0.76 mm. The distance between the superior, inferior optic edge and the iris ranged from 0.49 to 1.00 mm, 0.21 to 0.51 mm respectively. The shortest distance between the ICPIOL haptics and the angle of anterior chamber ranged from 1.25 to 1.65 mm. The indentation of iris tissue by the ICPIOL haptics without pigmentary dispersion and distortion of posterior curvature of iris was observed. CONCLUSION: Adequate space is maintained between the Verisyse myopic ICPIOL and the corneal endothelium, angle, and crystalline lens. Haptic indentation of the iris without pigment erosion and distortion of iris curvature is noted. The ICPIOL implanted in phakic eyes is a safe alternative for treatment of high myopia.