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PURPOSE: To investigate the postoperative clinical outcomes and axial length (AL) growth of infants with congenital cataracts and microphthalmos following first-stage cataract surgery. DESIGN: Retrospective case-control study. METHODS: Setting: Single centre. Infants with congenital cataract that met the inclusion criteria were classified into two groups: the microphthalmos and comparison groups. All infants underwent a thorough ophthalmologic examination before surgery, and one week, 1 month, 3 months, and every 3 months after surgery. RESULTS: This study enrolled 21 infants (42 eyes) in the microphthalmos group and 29 infants (58 eyes) in the comparison group. More glaucoma-related adverse events were observed in the microphthalmos group (7 eyes, 16.7%) than in the comparison group (0 eyes, 0%) (p < 0.001). At each subsequent follow-up, the comparison group had a greater AL than the microphthalmos group (all p < 0.001), and AL growth was significantly higher in the comparison group than in the microphthalmos group (all p = 0.035). Visual acuity improvement in the microphthalmos group was similar to that of the comparison group. CONCLUSION: Early surgical intervention improves visual function in infants with congenital cataracts and microphthalmos although with a higher incidence of glaucoma-related adverse events. After cataract removal, the AL growth of microphthalmic eyes is slower than that of normally developed eyes.
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Purpose: To evaluate the ability of swept-source optical coherence tomography angiography (SS-OCTA) to assess lid margin vascularity. Methods: This prospective, cross-sectional trial enrolled 125 participants, including 15 control subjects and 110 meibomian gland dysfunction (MGD) patients. Lid margin blood flow density (LMBFD) was obtained using SS-OCTA. LMBFD was assessed for repeatability in 54 of 125 participants and for reproducibility in 23 of 125 participants. The efficacy of LMBFD was validated in the 125 participants, who were divided into mild (n = 46), moderate (n = 42), and severe groups (n = 37) according to the lid margin vascularity severity shown in the slit-lamp photographs. Correlations between LMBFD and MG-related parameters, such as ocular surface disease index (OSDI), fluorescein tear break-up time (FTBUT), cornea fluorescein staining (CFS), lid margin score (LMS), and meibomian gland expressibility (ME), were analyzed in all 125 participants. Results: Repeatability and reproducibility coefficients were satisfactorily high in the scan mode with a scan area of 6 mm × 6 mm (intraclass correlation coefficient [ICC] repeatability = 0.905; ICC reproducibility = 0.986) and a scan area of 9 mm × 9 mm (ICC repeatability = 0.888; ICC reproducibility = 0.988). The LMBFD gradually increased in the mild, moderate, and severe groups (P < 0.001). LMBFD was significant correlated with OSDI (r = 0.290, P = 0.001), FTBUT (r = -0.195, P = 0.030), CFS (r = 0.352, P < 0.001), ME (r = 0.191, P = 0.033), and LMS (r = 0.370, P < 0.001). Conclusions: LMBFD may be a noninvasive, repeatable, reproducible, and efficient index for the quantitative evaluation of eyelid margin vascularity in the future. Translational Relevance: We demonstrated that SS-OCTA has the potential to evaluate the eyelid margin vascularity in MGD patients and guide future treatment strategies in clinics.
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Pálpebras , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Masculino , Feminino , Estudos Prospectivos , Estudos Transversais , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto , Pálpebras/irrigação sanguínea , Pálpebras/diagnóstico por imagem , Idoso , Disfunção da Glândula Tarsal/diagnóstico por imagem , Fluxo Sanguíneo Regional , Angiografia/métodos , Glândulas Tarsais/diagnóstico por imagemRESUMO
PURPOSE: To evaluate the predictive accuracy of modern intraocular lens (IOL) formulas and axial length (AL) adjusted traditional IOL formulas, including Wang-Koch and Cooke-modified AL (CMAL) method, in long eyes with plate-haptic IOLs, and to compare refractive prediction error variances with C-loop IOLs. DESIGN: Retrospective consecutive case series study. METHODS: Data from 391 eyes with Zeiss 509 M and 302 eyes with Alcon SN6CWS implants in highly myopic patients, following cataract surgery from January 2019 to November 2023, were collected. One eye per patient was selected. Predictive outcomes of 15 modern formulas (Barrett Universal II (BU II), Cooke K6 (K6), Emmetropia Verifying Optical (EVO) 2.0, Hoffer-QST, Kane, Karmona, Ladas AI, Naeser 2, Olsen, Pearl-DGS, Radial Basis Function (RBF) 3.0, T2, VRF-G, Zhu-Lu, and Z-Calc) and 4 traditional IOL formulas (Haigis, Hoffer Q, Holladay 1, and SRK/T) with AL adjusted methods, were evaluated. The mean prediction error, mean absolute prediction error (MAE), root-mean-square absolute prediction error (RMSAE) and the proportions of eyes with PEs within ±0.25 Diopter (D), ±0.50 D, ±0.75 D, and ±1.00 D were analyzed. Top 10 RMSAE-ranked formulas underwent further subgroup analysis based on AL, anterior chamber depth (ACD), and keratometry (K). RESULTS: For the 509 M group, RMSAE ranking for the top 10 IOL formulas were the RBF 3.0 (0.432), Zhu-Lu (0.436), Olsen (0.436), EVO 2.0 (0.437), Pearl-DGS (0.447), K6 (0.452), VRF-G (0.454), Naeser 2 (0.464), Haigis-CMAL (0.465) and Karmona (0.477). Karmona and Naeser 2 showed poorer performance in the extremely long AL and steep K subgroups, respectively (p ≤ 0.042). Haigis-CMAL accuracy was significantly lower in shallow ACD and flat K subgroups (P ≤ .045). The SN6CWS group showed significantly lower MAE and RMSAE compared to the 509 M group for the BU II, EVO 2.0, Hoffer-QST, Kane, Pearl-DGS, and Zhu-Lu formulas (P ≤ .024). CONCLUSIONS: In long eyes with plate-haptic IOLs, RBF 3.0 performed best, closely followed by Zhu-Lu, Olsen, and EVO 2.0; Karmona and Naeser 2 are discouraged for extreme AL and steep K conditions, respectively; Haigis-CMAL is not suggested for shallow ACD and flat K cases. Refractive outcomes in eyes implanted with a C-loop design IOL were more accurate than for those implanted with a plate-haptic design, for most tested formulas.
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Comprimento Axial do Olho , Biometria , Implante de Lente Intraocular , Lentes Intraoculares , Óptica e Fotônica , Desenho de Prótese , Refração Ocular , Acuidade Visual , Humanos , Estudos Retrospectivos , Feminino , Masculino , Refração Ocular/fisiologia , Acuidade Visual/fisiologia , Pessoa de Meia-Idade , Biometria/métodos , Comprimento Axial do Olho/patologia , Idoso , Miopia Degenerativa/fisiopatologia , Miopia Degenerativa/cirurgia , Facoemulsificação , Reprodutibilidade dos Testes , Pseudofacia/fisiopatologiaRESUMO
INTRODUCTION: The aim of this work is to evaluate the accuracy of the Barrett Universal II (BU II), Emmetropia verifying optical (EVO) 2.0, Haigis, Hoffer Q, Hoffer QST (Savini/Taroni) (HQST), Holladay 1, Kane, Ladas Super, Sanders-Retzlaff-Kraff/theoretical (SRK/T), and T2 intraocular lens (IOL) power formulas for calculating spherical equivalent (SE) of toric IOL. METHODS: This study enrolled consecutive patients who underwent phacoemulsification and toric IOL implantation at the Eye Hospital of Wenzhou Medical University in Hangzhou from 2015 to 2022. We compared the new-generation formulas with Gaussian optics-based standard formulas, and calculated the mean absolute error (MAE), median absolute error (MedAE), and percentage of eyes within ± 0.25 diopter (D), ± 0.50 D, ± 0.75 D and ± 1.00 D of the target refraction. Subgroup analyses were conducted based on the anterior chamber depth (ACD), keratometry (K), and toricity (T). RESULTS: A total of 207 eyes of 207 patients were included in this study. Overall, the Kane and EVO2.0 formulas demonstrated the lowest MedAEs. The EVO2.0 formula exhibited the highest percentage of eyes within ± 0.50 D, ± 0.75 D, ± 1.00 D. Moreover, the EVO2.0 formula showed the lowest MedAE for flat K subgroup, the highest percentage of eyes within ± 0.50 D, ± 1.00 D for shallow ACD subgroup, the highest percentage of eyes within ± 0.75 D for regular ACD, flat K, T2-T3, T4-T5 subgroups. The Kane and formula performed the lowest MedAE in the T4-T5 subgroup. CONCLUSIONS: Application of the Kane and EVO2.0 formulas significantly improved the prediction of postoperative SE outcome for toric IOL compared to the other formulas.
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Background and Aims: The National Standardized Training for Resident Doctors (STRD) in mainland China encounters many challenges in its implementation. To investigate whether outpatients are willing to undergo indirect ophthalmoscopy examination conducted by ophthalmology residents in the ophthalmology STRD program in China. Methods: This study conducted a cross-sectional survey at the Eye Hospital of Wenzhou Medical University between September 2021 and September 2023. A cohort of 300 initial outpatients requiring indirect ophthalmoscopy examinations were enlisted from the outpatient department. Based on whether the patients are willing to undergo an indirect ophthalmoscopy examination by resident doctors, patients were divided into two groups: Group 1 (willing) and Group 2 (unwilling), and their questionnaire responses were comparatively analyzed. Results: A total of 261/300 (87%) valid questionnaires were returned in the survey, which included 149 males and 112 females. No notable gender difference (p = 0.400) or disparity in medical expense categories (p = 0.786) was observed between the two groups. However, variables such as outpatient marital status (p = 0.002), the presence of training faculty during fundus examinations with residents and outpatients (p < 0.001), the demeanor of training residents toward patients (p < 0.001), and the quality of doctor-patient communication (p < 0.001) significantly varied between the groups. Conclusion: The level of outpatients' cooperation with ophthalmology residents during fundus examinations in the Chinese ophthalmology STRD program was observed to be low. Enhancing the presence of training faculty during examinations and enhancing the communication skills of training residents could significantly improve this situation.
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AIM: To investigate the efficacy of a new visual acuity (VA) screening method, the baby vision test for young children. METHODS: A total 105 eyes of 65 children aged 2-8y were included in the study. Acuity testing was conducted using a standardized recognition acuity chart (Snellen visual chart: at 3 m) and the baby vision model assessment. The baby vision device includes a screen, a near infrared camera and a computer. Children were seated at a measured distance of 33-40 cm from a display for testing. VA was estimated according to the highest resolution the children could follow. Decimal VA data were converted to logarithm of the minimum angle of resolution (logMAR) for statistical analysis. The VA results for each child were recorded and analyzed for consistency. RESULTS: The mean VA measured using the Snellen visual chart was 0.62±0.32, and that assessed using the baby vision test was 0.66±0.27. The 95% limit of agreement was -0.609 to 0.695, with 95.2% (100/105) plots within the 95% limits of agreement. VA values of the baby vision test were significantly correlated with those of the Snellen chart (R=0.274, P=0.005). CONCLUSION: The baby vision test can be used as a relatively reliable method for estimating VA in young children. This new acuity assessment might be a valid predictor of optotype-measured acuity later in preverbal children.
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PURPOSE: To investigate the effect of anterior capsule polishing on postoperative capsule opacification and capsular bend in patients with age-related cataract displaying normal axial length. SETTING: Eye Hospital of Wenzhou Medical University at Hangzhou. DESIGN: Prospective self-controlled trial. METHODS: Patients with age-related cataracts aged 56 to 84 years displaying normal axial length were enrolled. Before surgery, a coin-toss method was used to randomly select 1 eye for intraoperative 360 degrees anterior capsule polishing (polishing group); the contralateral eye received no treatment (control group). Capsular bend index (CBI), anterior capsule opacification (ACO), posterior capsule opacification (PCO), and anterior capsule opening area (ACOA) were recorded at 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively using swept-source optical coherence tomography and slitlamp examination. RESULTS: 21 patients (42 eyes) were enrolled. Within-group comparisons showed that both groups had significant differences in CBI between 1 week and 1 month postoperatively, and between 6 months and 12 months postoperatively ( P < .05). Between-group comparisons revealed a significant difference in CBI at 1 week postoperatively ( P < .05); at 12 months postoperatively, there was a significant difference in ACOA ( P < .05). There were no significant between-group differences regarding ACO or PCO at any timepoint ( P > .05). CONCLUSIONS: For patients with age-related cataracts and normal axial length, 360 degrees anterior capsule polishing can delay early capsular bag deformation without increasing the risks of ACO and PCO. This approach can also limit contraction of the anterior capsule opening.
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Cápsula Anterior do Cristalino , Opacificação da Cápsula , Facoemulsificação , Tomografia de Coerência Óptica , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cápsula Anterior do Cristalino/cirurgia , Opacificação da Cápsula/prevenção & controle , Capsulorrexe/métodos , Catarata , Cápsula do Cristalino/cirurgia , Cápsula do Cristalino/patologia , Implante de Lente Intraocular , Facoemulsificação/métodos , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Tomografia de Coerência Óptica/métodos , Acuidade Visual/fisiologiaRESUMO
OBJECTIVES: To identify factors associated with progressive anisometropia after bilateral intraocular lens (IOL) implantation in patients with pediatric cataract. METHODS: Clinical and standardized questionnaire data were collected for Sixty-eight patients with pediatric cataract (136 eyes) who underwent bilateral IOL implantation and at least 1 year of follow-up. Univariate and multivariate linear regression models were used to identify factors associated with postoperative anisometropia. RESULTS: The median age at IOL implantation was 3.2 years (range: 1-12.4 years), and median follow-up time was 5.7 years (range: 1.1-14 years). At 1 month postoperatively and at the last follow-up, there were 19 (27%) and 31 (46%) cases of anisometropia ≥1 D, 9 (13%) and 15 (22%) cases of anisometropia ≥2 D, and 2 (3%) and 9 (13%) cases of anisometropia ≥3 D, respectively. Compared with 1 month postoperatively, the amount of anisometropia increased in 45 (67%) patients. Greater anisometropia one year or more after bilateral IOL implantation was associated with larger intereye difference in IOL power (P = 0.032, 95%CI 0.013 to 0.285), intereye difference in preoperative axial length (P = 0.018, 95%CI -1.247 to -0.123), presence of strabismus (P = 0.017, 95%CI 0.063-0.601), anisometropia at 1 month postoperatively (P = 0.001, 95%CI 0.126-0.478), and intereye difference in axial length at the last follow-up (P = 0.047, 95%CI 0.005-0.627). CONCLUSION: Anisometropia might progress after bilateral IOL implantation in patients with pediatric cataract. Greater intereye difference in IOL power, presence of strabismus might increase the potential of progressive anisometropia.
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Anisometropia , Extração de Catarata , Catarata , Lentes Intraoculares , Estrabismo , Humanos , Criança , Lactente , Pré-Escolar , Extração de Catarata/efeitos adversos , Implante de Lente Intraocular , Anisometropia/etiologia , Acuidade Visual , Catarata/complicações , SeguimentosRESUMO
Corneal neovascularization (CNV) is a vision-threatening disease that is becoming a growing public health concern. While Yes-associated protein (YAP) plays a critical role in neovascular disease and allow for the sprouting angiogenesis. Verteporfin (VP) is a classical inhibitor of the YAP-TEAD complex, which is used for clinical treatment of neovascular macular degeneration through photodynamic therapy. The purpose of this study is to explore the effect of verteporfin (VP) on the inhibition of CNV and its potential mechanism. Rat CNV model were established by suturing in the central cornea and randomly divided into three groups (control, CNV and VP group). Neovascularization was observed by slit lamp to extend along the corneal limbus to the suture line. RNA-sequencing was used to reveal the related pathways on the CNV and the results revealed the vasculature development process and genes related with angiogenesis in CNV. In CNV group, we detected the nuclear translocation of YAP and the expression of CD31 in corneal neovascular endothelial cells through immunofluorescence. After the application of VP, the proliferation, migration and the tube formation of HUVECs were significantly inhibited. Furthermore, VP showed the CNV inhibition by tail vein injection without photoactivation. Then we found that the expression of phosphorylated YAP significantly decreased, and its downstream target protein connective tissue growth factor (CTGF) increased in the CNV group, while the expression was just opposite in other groups. Besides, both the expression of vascular endothelial growth factor receptor 2 (VEGFR2) and cofilin significantly increased in CNV group, and decreased after VP treatment. Therefore, we conclude that Verteporfin could significantly inhibited the CNV without photoactivation by regulating the activation of YAP.
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Neovascularização de Coroide , Neovascularização da Córnea , Verteporfina , Animais , Ratos , Neovascularização de Coroide/tratamento farmacológico , Neovascularização de Coroide/metabolismo , Neovascularização da Córnea/tratamento farmacológico , Células Endoteliais/metabolismo , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Fator A de Crescimento do Endotélio Vascular/metabolismo , Verteporfina/farmacologia , Verteporfina/uso terapêuticoRESUMO
Background: Since blinking accelerates meibomian gland (MG) expression, abnormal blinking in children with tic disorders may be associated with the morphological changes of the MGs. Our study aimed to quantitively evaluate the morphology of the MG in these children. Methods: In this prospective case-control study, we examined 68 eyes of 68 children with tic disorders, 47 eyes of 47 children with dry eye, and 45 eyes of 45 healthy children at the Hangzhou Branch of the Eye Hospital of Wenzhou Medical University from October 2020 to March 2021. We used an Oculus Keratograph 5M (K5M) to capture the MG images, noninvasive breakup time (NIBUT), and tear meniscus height (TMH). An automated method was used to analyze MG length, width, area, gland diameter deformation index (DI), and gland signal index (SI). Parameters across the three groups were assessed using Kruskal-Wallis test followed by Mann-Whitney test with Bonferroni correction for multiple comparisons. Results: The eyes in the tic disorders group exhibited lower MG length and area values compared with those of the other groups (all P values <0.001) and lower MG width values compared with those of children in the dry eye group (P=0.009). The tic disorder and dry eye groups both had a larger percentage of eyes with a U-shaped MG duct when compared with the control group (P<0.001 and P=0.017). The dry eye group had the lowest TMH and NIBUT values (both P values <0.001). The NIBUT values in the tic disorder group were lower than those in the control group (P<0.001). No significant correlations were detected between clinical tests and MG morphology in any of the groups. Conclusions: Blinking disorders have a significant impact on MG morphology. In children with tic disorders, more attention should be devoted to monitoring the MG over time.
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Purpose: This study aimed to establish an image-based classification that can reveal the clinical characteristics of patients with dry eye using unsupervised learning methods. Methods: In this study, we analyzed 82,236 meibography images from 20,559 subjects. Using the SimCLR neural network, the images were categorized. Data for each patient were averaged and subjected to mini-batch k-means clustering, and validated through consensus clustering. Statistical metrics determined optimal category numbers. Using a UNet model, images were segmented to identify meibomian gland (MG) areas. Clinical features were assessed, including tear breakup time (BUT), tear meniscus height (TMH), and gland atrophy. A thorough ocular surface evaluation was conducted on 280 cooperative patients. Results: SimCLR neural network achieved clustering patients with dry eye into six image-based subtypes. Patients in different subtypes harbored significantly different noninvasive BUT, significantly correlated with TMH. Subtypes 1 and 5 had the most severe MG atrophy. Subtype 2 had the highest corneal fluorescent staining (CFS). Subtype 4 had the lowest TMH, whereas subtype 5 had the highest. Subtypes 3 and 6 had the largest MG areas, and the upper MG areas of a person's bilateral eyes were highly correlated. Image-based subtypes are related to meibum quality, CFS, and morphological characteristics of MG. Conclusions: In this study, we developed an unsupervised neural network model to cluster patients with dry eye into image-based subtypes using meibography images. We annotated these subtypes with functional and morphological clinical characteristics.
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Síndromes do Olho Seco , Aprendizado de Máquina não Supervisionado , Humanos , Síndromes do Olho Seco/diagnóstico por imagem , Síndromes do Olho Seco/patologia , Glândulas Tarsais/patologia , Lágrimas , Atrofia/patologiaRESUMO
PURPOSE: To evaluate the accuracy of newer online intraocular lens (IOL) formulas in extremely elongated eyes (axial length > 30 mm). METHODS: This retrospective case series study included 236 patients (236 eyes). Postoperative refractive outcomes of the Barrett Universal II (BU II), Cooke K6 (K6), Emmetropia Verifying Optical (EVO) 2.0, Hoffer QST (HQST), Kane, Pearl-DGS, and Radial Basis Function (RBF) 3.0 formulas were compared. Subgroup analysis was performed in the extreme myopia group 1 (30 < axial length ≤ 32 mm), extreme myopia group 2 (32 < axial length ≤ 35 mm), and meniscus IOL group. The root mean square absolute prediction error (RMSAE) and proportions of eyes of prediction errors within ±0.50 diopters (D) were calculated for statistical analysis. RESULTS: For the extreme myopia group 1, RBF 3.0 achieved the lowest RMSAE (0.361) and EVO 2.0 showed the highest proportion of eyes within ±0.50 diopters (85.06%). For the extreme myopia group 2, the RMSAE of the K6 (0.442) and EVO 2.0 (0.475) was significantly lower than the BU II (0.610), Kane (0.641), and HQST (0.759, P ≤ .016) formulas. In the meniscus IOL group, the K6 formula showed the lowest RMSAE (0.402) and the highest percentage within ±0.50 diopters (84.31%). CONCLUSIONS: The EVO 2.0 and K6 formulas are recommended for IOL power calculation in eyes with extreme myopia. Modern artificial intelligence-based formulas should be used cautiously when the axial length is longer than 32 mm or meniscus IOLs are implanted. [J Refract Surg. 2023;39(10):705-710.].
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Lentes Intraoculares , Miopia , Facoemulsificação , Humanos , Estudos Retrospectivos , Inteligência Artificial , Biometria , Refração Ocular , Miopia/cirurgia , Óptica e Fotônica , Comprimento Axial do OlhoRESUMO
Cataract is the first leading cause of blindness in the world and posterior capsule opacification (PCO) is the most common long-term complication after surgery. The primary pathogenic processes contributing to PCO are the proliferation and migration of residual lens epithelial cells (LECs). This study aimed to explore the mild photothermal effect on LECs. Interestingly, this work finds that the mild photothermal effect significantly inhibited the proliferation and migration of LECs. The live cell fluorescence imaging reveals that the remodeling of the actin cytoskeleton and cell morphology attributed to the inhibition effect. Further mechanistic studies at molecular level suggest that the mild photothermal effect can regulate the phosphorylation of ERM, YAP, and Cofilin and thereby affect the proliferation and migration of LECs. In order to explore the potential clinical application of mild photothermal therapy for PCO prevention, PDA/PVA gel rings with photothermal effect is prepared by the repeated freeze-thaw method and conducted experiments in vivo, which achieved favorable PCO prevention effect. Overall, this study shows that the mild photothermal effect can regulate the proliferation and migration of LECs through cytoskeletal remodeling and the results of experiments in vivo demonstrate that mild photothermal effect is a promising approach for PCO prevention.
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Opacificação da Cápsula , Humanos , Opacificação da Cápsula/prevenção & controle , Opacificação da Cápsula/patologia , Terapia Fototérmica , Proliferação de Células , Movimento Celular , Células EpiteliaisRESUMO
PURPOSE: To investigate the effect of corneal curvature (K) on the accuracy of 8 intraocular lens formulas in highly myopic eyes. SETTING: Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China. DESIGN: Retrospective consecutive case series. METHODS: 302 eyes (302 patients) were analyzed in subgroups based on the K value. The mean refractive error, mean absolute error (MAE), median absolute error (MedAE), root-mean-square absolute prediction error (RMSAE) and proportions of eyes within ±0.25 diopter (D), ±0.50 D, ±0.75 D, ±1.00 D were statistical analyzed. RESULTS: Emmetropia Verifying Optical (EVO) 2.0, Kane, and Radial Basis Function (RBF) 3.0 had the lower MAE (≤0.28) and RMSAE (≤0.348) and highest percentage of eyes within ±0.50 D (≥83.58%) in the flat (K ≤ 43 D) and steep K (K > 45 D) groups. Hoffer QST had the lowest MedAE (0.19), RMSAE (0.351) and the highest percentage of eyes within ±0.50 D (82.98%) in the normal K group (43 < K ≤ 45 D). When axial length (AL) ≤28 mm, all formulas showed close RMSAE values (0.322 to 0.373) in flat K group. When AL >28 mm, RBF 3.0 achieved the lowest MAE (≤0.24), MedAE (≤0.17) and RMSAE (≤0.337) across all subgroups. CONCLUSIONS: EVO 2.0, Kane, and RBF 3.0 were the most accurate in highly myopic eyes with a flat or steep K. Hoffer QST is recommended for long eyes with normal K values. RBF 3.0 showed the highest accuracy when AL >28 mm, independent of corneal curvature.
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Lentes Intraoculares , Miopia , Facoemulsificação , Humanos , Refração Ocular , Implante de Lente Intraocular , Estudos Retrospectivos , Comprimento Axial do Olho , Miopia/cirurgia , Biometria , Óptica e FotônicaRESUMO
PURPOSE: To determine the full-field electroretinogram (ffERG) parameters, including the light-adapted (LA) 3 ERG and the photopic negative response (PhNR), in 6- to 12-year-old children. METHODS: ffERG data were obtained from 214 eyes of 214 healthy subjects. The amplitudes and peak time of the ffERG responses were obtained from children divided into 6- to 8-year-old and 9- to 12-year-old groups. Using a skin electrode, electrical signals were measured in response to white stimulating light and white background light (LA 3 ERG). A blue background light and red flashes were then used to elicit the PhNR. RESULTS: The a-wave amplitude ranged from 0.40 to 9.20 µV, the b-wave ranged from 4.70 to 30.80 µV, and the PhNR ranged from 1.30 to 39.90 µV. The b-wave peak time (33.20 ms) of 6- to 8-year-old groups was slightly shorter than that of the 9- to 12-year-old groups (33.60 ms, P = 0.01), but no differences in amplitudes or in peak time of other components. There were significant correlations between the amplitudes (a-wave and b-wave: r = 0.43, p < 0.001; a-wave and PhNR: r = 0.25, p < 0.001; b-wave and PhNR: r = 0.45, p < 0.001). There was a moderate correlation between the a-wave and b-wave peak time (r = 0.31, P < 0.001). CONCLUSIONS: We determined the largest dataset of the LA 3 ERG and PhNR parameters in a population of healthy children, aged 6-12 years, which may provide a useful reference value when evaluating children with potential retinal defects.
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Eletrorretinografia , Células Ganglionares da Retina , Humanos , Criança , Células Ganglionares da Retina/fisiologia , Estimulação Luminosa , Retina/fisiologia , EletrodosRESUMO
AIM: To evaluate optic nerve head (ONH) vessel density (VD) changes after cataract surgery using optical coherence tomography angiography (OCTA). METHODS: This was a prospective observational study. Thirty-four eyes with mild/moderate cataracts were included. ONH scans were obtained before and 3mo after cataract surgery using OCTA. Radial peripapillary capillary (RPC) density, all VD, large VD and retinal nerve fiber layer thickness (RNFLT) in total disc, inside disc, and different peripapillary sectors were assessed and analyzed. Image quality score (QS), fundus photography grading and best-corrected visual acuity (BCVA) were also collected, and correlation analyses were performed between VD change and these parameters. RESULTS: Compared with baseline, both RPC and all VD increased in inside disc area 3mo postoperatively (from 47.5%±5.3% to 50.2%±3.7%, and from 57.87%±4.30% to 60.47%±3.10%, all P<0.001), but no differences were observed in peripapillary area. However, large VD increased from 5.63%±0.77% to 6.47%±0.72% in peripapillary ONH region (P<0.001). RPC decreased in inferior and superior peripapillary ONH parts (P=0.019, <0.001 respectively). There were obvious negative correlations between RPC change and large VD change in inside disc, superior-hemi, and inferior-hemi (r=-0.419, -0.370, and -0.439, P=0.017, 0.044, and 0.015, respectively). No correlations were found between VD change and other parameters including QS change, fundus photography grading, postoperative BCVA, and postoperative peripapillary RNFLT. CONCLUSION: RPC density and all VD in the inside disc ONH region increase 3mo after surgery in patients with mild to moderate cataract. No obvious VD changes are found in peripapillary area postoperatively.
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Purpose: To describe neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser treatment of visual axis opacification and secondary membranes in pediatric patients with cataracts under intranasal dexmedetomidine sedation. Methods: Twenty eyes of 17 patients with secondary membrane formation after cataract extraction were enrolled in this study. Intranasal dexmedetomidine sedation (3â ug/kg) was administered, and Nd:YAG laser (Ellex Super Q, Adelaide, Australia) procedures were performed with children in the sitting position with their chin supported on a laser delivery slit lamp. Preoperative and postoperative visual acuities were documented, and medical records were reviewed. Results: The age of the patients ranged from 5 to 83 months (31.82 ± 27.73). Nineteen (95.0%) eyes had congenital cataracts and one (5.0%) had a traumatic cataract. Nd:YAG laser treatment of VAO with ten (50.0%) eyes, pupillary membranes with three (15.0%) eyes, pupillary cortical proliferation with six (30.0%) eyes, and anterior capsule contraction with one (5.0%) eye. Five (25.0%) eyes demonstrated visual acuity improvement, whereas six (30.0%) eyes remained unchanged after laser treatment. The recurrence rate was 30.0% and four eyes underwent a second Nd:YAG membranectomy. No side effects or tolerances due to sedative drugs were observed. Conclusion: Nd:YAG laser membranectomy under intranasal dexmedetomidine sedation was safely performed in children as young as 5 months old in a sitting position. This approach facilitates patient convenience, doctor proficiency, and cost reductions. Patients with recurrence can be treated by repeating the procedure.
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PURPOSE: To evaluate the correlation between lens density measured by IOL-Master 700 based on swept-source optical coherence tomography (SS-OCT) technology and the phacodynamic parameters of Centurion phacoemulsification in cataract surgery. METHODS: This prospective study included 66 patients (83 eyes) with age-related cataracts. Using the Lens Opacities Classification System III (LOCS III), the lens nuclear color (NC), lens nuclear opalescence (NO), cortical (C), and posterior subcapsular (P) opacities were obtained. Six meridian orientations of IOL-Master 700 images were captured, and the lens and nuclear regions were analyzed using ImageJ to generate the average lens nucleus density (AND) and average lens density (ALD). Phacodynamic parameters were recorded. The correlation between lens density and the phacodynamic parameters was analyzed. According to the AND, patients were divided into four groups (soft, medium-hard, hard, and extremely hard nucleus), and the phacodynamic parameters were compared among groups. RESULTS: The correlation between the AND obtained by LOCS III grading and SS-OCT-based cataract quantification system score (NC and NO) was statistically significant (rNC = 0.795, rNO=0.794, both p = .000). AND correlated significantly with cumulative dissipated energy (CDE, r = 0.545, p = .000), total ultrasound time (TUST, r = 0.354, p = .001), and total torsional ultrasound time (TTUT, r = 0.314, p = .004). Among the four groups divided by AND, the difference in CDE (P13 = 0.002, P14 < 0.001, P24 = 0.002) was statistically significant. CONCLUSION: AND measured by IOL-Master 700, SS-OCT correlated significantly with LOCS III classification and phacodynamic parameters of the Centurion system, especially with CDE, TUST, and TTUT. AND can be used as an indicator for quantitative evaluation and help inform the surgical plan.
Assuntos
Catarata , Cristalino , Facoemulsificação , Humanos , Facoemulsificação/métodos , Tomografia de Coerência Óptica/métodos , Estudos Prospectivos , Cristalino/diagnóstico por imagem , Catarata/diagnósticoRESUMO
PURPOSE: To evaluate the accuracy of newer generation intraocular lens (IOL) power calculation formulas (EVO 2.0 and Kane) with established formulas (Barrett Universal II, Haigis and SRK/T) in pediatric cataract patients. METHODS: Retrospective study. We enrolled 110 eyes (110 patients) in Eye Hospital of Wenzhou Medical University. All patients underwent uneventful cataract surgery and implanted with posterior chamber IOL in the bag. We calculate the mean prediction errors (PE) and percentage within 1 diopter (D) at 1 month to assess the accuracy, and percentage > 2D was defined as prediction accident. Then, we performed subgroup analysis according to age and axial length (AL). RESULTS: The mean age and AL were 37.45 ± 23.28 months and 21.16 ± 1.29 mm. The mean PE for all patients was as follows: Barrett (- 0.30), EVO (0.18), Haigis (- 0.74), Kane (- 0.36), and SRK/T (0.58), p < 0.001. In addition, EVO and SRK/T formulas were relatively accurate in patients younger than 24 months and with AL ≤ 21 mm, while EVO got lower prediction accident rate than SRK/T (3/41 vs 8/41, 4/52 vs 5/52). Moreover, Barrett, EVO, and Kane formulas achieved better accuracy and lower prediction accident rate in patients older than 24 months and with AL > 21 mm (both > 51/69 and 43/58, and < 3/69 and 3/58). CONCLUSIONS: In patients older than 24 months and with AL > 21 mm, Barrett, EVO, and Kane formulas were relatively accurate, while in patients younger than 24 months and with AL ≤ 21 mm, EVO was more accurate, followed by SRK/T formula.
Assuntos
Catarata , Lentes Intraoculares , Facoemulsificação , Humanos , Criança , Refração Ocular , Acuidade Visual , Estudos Retrospectivos , Óptica e Fotônica , Catarata/complicações , Biometria , Comprimento Axial do OlhoRESUMO
PURPOSE: To investigate the characteristics of eyes with large variations in predicted refraction using four traditional intraocular lens (IOL) formulas and evaluate the accuracy of new-generation intraocular lens power calculation formulas. METHODS: Eyes that had variation in predicted refraction (≥ 0.75 D) using four traditional formulas (SRK/T, Holladay 1, Hoffer Q, and Haigis formulas) were included. Axial length (AL), anterior chamber depth (ACD), average keratometry (AK), and the ratio of axial length to corneal radius (AL/CR) were measured. New-generation formulas (Barrett Universal II, Emmetropia Verifying Optical 2.0, Kane, and Pearl-DGS formulas) and traditional formulas were compared. The median absolute error (MedAE) was the main parameter to evaluate the accuracy of formulas. RESULTS: A total of 79 participants (79 eyes) who had variation in predicted refraction of (≥ 0.75 D) using four traditional formulas out of 510 eyes (510 patients) underwent uncomplicated cataract surgeries. The Barrett Universal II (0.29 D), EVO 2.0 (0.31 D), Kane (0.30 D), and Pearl-DGS (0.33 D) formulas produced significantly lower median absolute errors (MedAEs) than the Hoffer Q (0.61 D) and Holladay 1 (0.59 D) formulas (P < 0.01). The Wang-Koch (WK) adjustment significantly improved the accuracy of the Holladay 1 formula in long eyes (P < 0.001). CONCLUSIONS: Abnormal AL, ACD, and AK are more likely to lead to prediction errors using traditional formulas. New-generation formulas and traditional formulas with WK adjustment showed satisfactory prediction accuracy.