Effect of Low-Concentration Atropine Eye Drops in Controlling the Progression of Myopia in Children: A One- and Two-Year Follow-Up Study.

PURPOSE: Atropine eye drops have been shown to slow the progression of myopia, but there has been limited research on the effectiveness of 0.05% atropine in treating myopia. This study aimed to investigate the safety and efficacy of 0.05% atropine eye drops in controlling myopia in children. METHODS: The study included 424 participants aged 6 to 12 years between January 1, 2015, and January 1, 2021. Of these, 213 were randomly assigned to the 0.05% atropine group and 211 to the placebo group. The cycloplegic spherical equivalent (SE), axial length (AL), corneal curvature (K), and anterior chamber depth (ACD) were measured using IOLMaster. The lens power and corneal astigmatism were also determined. The changes in ocular biometric parameters were compared between the two groups, and the contributions of ocular characteristics to SE progression were calculated and compared. RESULTS: Over a 12-month period, the changes in spherical equivalent were -0.03 ± 0.28 and -0.32 ± 0.14 in the atropine and placebo groups, respectively (P = .01). The changes in axial length were 0.06 ± 0.11 and 0.17 ± 0.12, respectively (P = .01). At 18 and 24 months, there were significant differences in axial length and spherical equivalent between the atropine and placebo groups. Multiple regression models accounting for changes in AL, K, and lens magnification explained 87.23% and 98.32% of SE changes in the atropine and placebo groups, respectively. At 1 year (p = .01) and 2 years (p = .03), there were significant differences in photophobia between the atropine and placebo groups. CONCLUSIONS: This two-year follow-up study demonstrates that 0.05% atropine eye drops are safe and effective in preventing the development of myopia in school-aged children.

Autonomous robotic surgery for zygomatic implant placement and immediately loaded implant-supported full-arch prosthesis: a preliminary research.

OBJECTIVES: A patient with extensive atrophy of the alveolar ridge in the posterior portion of the maxilla was selected to complete an experimental and clinical case of the robotic zygomatic implant to investigate the viability of an implant robotic system in clinical use. METHODS: The preoperative digital information was collected, and the implantation position and personalized optimization marks needed for robot surgery were designed in advance in a repair-oriented way. The resin models and marks of the patient's maxilla and mandible are all printed in 3D. Custom-made special precision drills and handpiece holders for robotic zygomatic implants were used to perform model experiments and compare the accuracy of the robotic zygomatic implant group (implant length = 52.5 mm, n = 10) with the alveolar implant group (implant length = 18 mm, n = 20). Based on the results of extraoral experiments, a clinical case of robotic surgery for zygomatic implant placement and immediate loading of implant-supported full arch prosthesis was carried out. RESULTS: In the model experiment, the zygomatic implant group reported an entry point error of 0.78 ± 0.34 mm, an exit point error of 0.80 ± 0.25 mm, and an angle error of 1.33 ± 0.41degrees. In comparison, the alveolar implant group (control group) reported an entry point error of 0.81 ± 0.24 mm, an exit point error of 0.86 ± 0.32 mm, and an angle error of 1.71 ± 0.71 degrees. There was no significant difference between the two groups (p > 0.05). In clinical cases, the average entry point error of two zygomatic implants is 0.83 mm, the average exit point error is 1.10 mm and the angle error is 1.46 degrees. CONCLUSIONS: The preoperative planning and surgical procedures developed in this study provide enough accuracy for robotic zygomatic implant surgery, and the overall deviation is small, which is not affected by the lateral wall deviation of maxillary sinus.

Refractive errors and ocular findings in children and adolescents with mental disorders: a retrospective study.

BACKGROUND: An increasing prevalence of mental disorders (MDs) has been reported among children and adolescents. However, only few studies have conducted ocular examinations, including those on refractive status, in these groups of patients. Thus, the purpose of this study was to evaluate the refractive status and ocular findings in children and adolescents with MDs compared with matched controls with similar socioeconomic backgrounds. METHODS: A total of 178 participants with MDs and 200 controls were recruited between April 2021 and May 2022. All the children and adolescents underwent cycloplegic or noncycloplegic autorefraction and retinoscopy, slit-lamp biomicroscopy, and dilated fundus examinations. Ocular alignment was assessed using Hirschberg, Krimsky, or prism cover tests. The prevalence of refractive errors and ocular findings was the main outcome. RESULTS: Twenty-seven percent of patients with MDs and 8% of controls had ocular findings, the most common of which were conjunctivitis, keratitis, and trichiasis. For refractive status, 70% (124/178) of patients with MDs had myopia ≤-1.00 DS, and 2% (4/178) had hyperopia ≥+2.00 DS. In the control group, 70% (140/200) of patients had myopia ≤-1.00 DS, and 1% (2/200) had hyperopia ≥+2.00 DS. No differences were observed between the MD and control groups. However, the patients in the MD group (14.25±2.69 years) were significantly more susceptible to strabismus (P<0.05) and amblyopia (P<0.01) than those in the control group (13.65±3.04 years). There was a substantial difference between the two groups in the time spent on screen-based devices (P<0.001). Furthermore, mental retardation (OR=3.286, P<0.01), emotional disorders (OR=2.003, P<0.01), and adjustment disorders (OR=2.629, P<0.01) were associated with an increased risk of amblyopia. Depression (OR =1.362, P<0.01) and emotional disorders (OR=2.205, P<0.01) were associated with a higher prevalence of strabismus. CONCLUSION: Ophthalmological examinations should be performed in children and adolescents with MDs because MDs are associated with a high prevalence of refractive errors and ocular diseases. Detection and intervention of ocular and refractive findings in children and adolescents with MDs are necessary and effective in alleviating the economic burden in healthcare and improving individuals' quality of life.

Effect of treatment zone decentration on axial length growth after orthokeratology.

Objective: To study the effect of treatment zone (TZ) decentration on axial length growth (ALG) in adolescents after wearing the orthokeratology lenses (OK lenses). Materials and methods: This retrospective clinical study selected 251 adolescents who were fitted OK lenses at the Clinical College of Ophthalmology, Tianjin Medical University (Tianjin, China) from January 2018-December 2018 and wore them continuously for >12 months. The age of the subjects was 8-15 years, spherical equivalent (SE): -1.00 to -5.00 diopter (D), and astigmatism ≤ 1.50 D. The corneal topography were recorded at baseline and 1-, 6-, and 12-month visits, and the axial length (AL) were recorded at baseline and 6-, 12-month visits. The data of the right eye were collected for statistical analysis. Results: The subjects were divided into three groups according to the decentration distance of the TZ after wearing lenses for 1 month: 56 cases in the mild (<0.5 mm), 110 in the moderate (0.5-1.0 mm), and 85 in the severe decentration group (>1.0 mm). A significant difference was detected in the ALG between the three groups after wearing lenses for 6 and 12 months (F = 10.223, P < 0.001; F = 13.380, P < 0.001, respectively). Among these, the 6- and 12-month ALG of the mild decentration group was significantly higher than that of the other two groups. Multivariable linear regression analysis showed that age, baseline SE, and 1-month decentration distance associated with the 12-month ALG (P < 0.001, P < 0.001, and P = 0.001, respectively). Conclusion: The decentration of the TZ of the OK lens affected the growth of the AL in adolescents, i.e., the greater the decentration, the slower the ALG.

Comparison of Biological Characteristics of Different Paranasal Sinus Mucosa in Goats.

BACKGROUND/PURPOSE: Prosthetic implants are the primary treatment for patients with edentulism. This study aims to explore and compare the biological characteristics of mucosal thickness and tensile strength of the paranasal sinuses (maxillary and frontal sinuses) in goats, thereby providing a theoretical basis and guidance for mucosa-related problems involved in maxillary sinus lifting. MATERIALS AND METHODS: The paranasal sinus mucosa (maxillary sinus crest, maxillary sinus floor and frontal sinus mucosa) was obtained from the goats for use in maxillary sinus lifting. The mucosa was made into tissue section specimens and evaluated by a computer with built-in screenshot software and an optical microscope with a graduated eyepiece. A total of 3 readings were randomly selected and recorded. The mucosa was clamped with a laboratory-made clamp device. After connecting the push-pull meter, the mucosa exposed by the inner ring of the clamp device was pressed vertically and uniformly until it ruptured. The strength value was read and recorded. The left and right ends of the mucosa were connected with the clamp device; horizontal tension was applied evenly to the mucosa until the mucosa ruptured. The strength value was read and recorded. The normality test, analysis of variance, LSD pairwise comparison and linear regression were performed for each group of data. RESULTS: The thicknesses of the maxillary sinus crest mucosa, floor mucosa and frontal sinus mucosa in goats were 410.03 ± 65.97 um, 461.33 ± 91.37 um and 216.90 ± 46.47 um, respectively. There were significant differences between the maxillary sinus crest and frontal sinus and the maxillary sinus floor and frontal sinus (P < .05). The range of tensile strength of the maxillary sinus crest mucosa, floor mucosa and frontal sinus mucosa in goats was 0.48 ± 0.10 kg, 0.54 ± 0.11kg and 0.20 ± 0.05kg, respectively. There were significant differences between the maxillary sinus crest and frontal sinus and the maxillary sinus floor and frontal sinus (P < .05). Tensile strength was positively correlated with the thickness of the mucosa of the maxillary and frontal sinuses (P < .05). CONCLUSION: The mucosal thickness and tensile strength of the maxillary sinus crest and floor were greater than those of the frontal sinus mucosa. There was a positive correlation between the tensile strength and the thickness of the mucosa.

Effect of synchronous irrigation on cyclic fatigue of nickel-titanium instrument in the dynamic and static models.

OBJECTIVE: To evaluate the effect of synchronous water irrigation on the fatigue resistance of nickel-titanium instrument. METHODS: A standardized cyclic fatigue test models were established, and five types of nickel-titanium instruments (PTU F1, WO, WOG, RE, and M3) were applied. Each instrument was randomly divided into two groups (N = 12). There was synchronous water irrigation in the experimental group, and no water irrigation in the control group. Besides, ProTaper Universal F1 was randomly divided into 10 groups (N = 20). In the static group, nickel-titanium instruments were divided into one control group (no irrigation, N = 20) and six experimental group (irrigation, N = 20) based on different flow rate, angle and position; while in the dynamic group, instruments were divided into one control group (no irrigation, N = 20) and two experimental group (irrigation, N = 20) based on different flow rate. The rotation time (Time to Failure, TtF) of instruments was recorded and analyzed. RESULTS: According to the static experiments, the TtF of instruments in all experimental groups was significantly higher than that in the static control group. Besides, the dynamic tests of PTU F1 showed that the TtF in the experimental group was significantly higher than that in the dynamic control group. Compared with control group, the TtF in the experimental groups increased by at least about 30% and up to 160%. The static and dynamic tests of PTU F1 showed that the TtF of nickel-titanium instrument in all experimental groups was significantly higher than that in the control group. However, there was no significant difference between any two experimental groups. CONCLUSION: Regardless of dynamic or static model, TtF with irrigation was longer than that with non-irrigation, indicating that synchronous irrigation can increase the fatigue resistance of nickel-titanium instrument. However, different irrigation conditions may have the same effect on the fatigue resistance.

The Effect of Relative Corneal Refractive Power Shift Distribution on Axial Length Growth in Myopic Children Undergoing Orthokeratology Treatment.

PURPOSE: To quantify the spatial distribution of relative corneal refractive power shift (RCRPS) to investigate its association with axial length growth. METHODS: Eighty myopic children were randomly assigned for fitting with type A or B lenses. Axial lengths and corneal topographies were measured at baseline and the 1-, 6-, and 12-months follow-up visits. Treatment-zone decentrations and sizes were derived from tangential maps. RCRPSs were computed by taking the difference between after-treatment and baseline axial maps and then subtracting the apex value. Values at the same radius were averaged to obtain an RCRPS profile, from which four distributional parameters were extracted: the peak value (Rmax), the location where the profile first reached its half peak (X50), and the powers summed within 4- and 8-mm diameter areas (Sum4 and Sum8, respectively). Linear mixed models were used to analyse the correlation between the AL growth and the distributional parameters. RESULTS: At baseline, no significant differences were observed between the two groups. After treatment, Axial length growth was significantly smaller in subjects fitted with type-B lenses (0.15 ± 0.16 vs 0.25 ± 0.22 mm, P = .028). Smaller treatment-zones (1.56 ± 0.14 vs 1.75 ± 0.13 mm, P < .01), smaller X50 values (1.56 ± 0.39 vs 1.98 ± 0.28 mm, P < .01), and greater Sum4 values (11.83 ± 6.47 vs 8.14 ± 5.06 D, P = .01) were also observed in subjects wearing type-B lenses. Among the distributional parameters, only X50 was significantly associated with AL growth in the multiple regression analysis (P = .005). CONCLUSION: The spatial distribution of RCRPS is critical in retarding AL growth, and the ones reaching peak within a shorter distance from the apex may provide better myopia control.

[Clinical research on mild and moderate carpal tunnel syndrome treated with contralateral needling technique at distal acupoints and acupuncture at local acupoints].

OBJECTIVE: To compare the differences in the clinical therapeutic effects on mild and moderate carpal tunnel syndrome between the combined therapy of regular acupuncture and contralateral needling technique at distal acupoints and the regular acupuncture. METHODS: Sixty patients of mild and moderate carpal tunnel syndrome were divided into an observation group and a control group according to random number table, 30 cases in each one. Laogong (PC 8), Daling (PC 7), Neiguan (PC 6), Yuji (LU 10) and Hegu (LI 4) were selected on the affected side in the two groups. In the observation group, the reducing needling technique with lifting and thrusting was applied at first to Taichong (LR 3) and Zhongfeng (LR 4) on the opposite side and afterwards those on the affected side were stimulated. In the control group, acupuncture was given at the acupoints on the affected side. The even-needling technique was used at the acupoints on the affected side in the patients of the two groups. Acupuncture was given once every day, 30 min each time. The treatment for 10 days was as one session. The therapeutic effects were evaluated after 3 sessions. The changes in median nerve electrophysiology, Levine's carpal tunnel syndrome questionnaire, the patient-rated wrist evaluation (PRWE) and the evaluation of therapeutic effects were observed before and after treatment in the two groups. RESULTS: The total effective rate was 90.0% (27/30) in the observation group, better than 70.0% (21/30) in the control group (P<0.05). After treatment, the nerve sensory conduction velocity and the amplitude of median nerve were all increased in the two groups, indicating the significant differences (all P<0.05). The increase in the observation group was more apparent than that in the control group (all P<0.05). The symptom severity score (SSS) and function status score (FSS) were all reduced apparently after treatment in the two groups (both P<0.05). SSS and FSS in the observation group were lower apparently than those in the control group after treatment (both P<0.05). PRWE score after treatment was reducedapparently as compared with that before treatment in the two groups (both P<0.05). The result in the observation group was lower than that in the control group after treatment (P<0.05). CONCLUSIONS: The combined treatment of regular acupuncture technique and the contralateral needling technique at distal acupoints achieves the definite therapeutic effects on mild and moderate carpal tunnel syndrome, apparently superior to the regular needling technique.