The efficacy of bandage contact lens in relieving the aggravation of dry eye disease after complicated cataract or/and IOL surgery.

PURPOSE: In the present study, we aimed to evaluate the efficacy of the bandage contact lens (BCLs) in the treatment of dry eye disease (DED) after complicated cataract or/and intraocular lens (IOL) surgery. METHODS: In this retrospective, single-centered, observational study, we collected data from 69 patients who underwent complicated cataract or/and IOL surgery. Of these, 35 cases wore their own BCLs immediately after the operation, while the other 34 cases did not have their own BCLs and were instead covered with gauze. The Ocular Surface Disease Index (OSDI) questionnaire, slit-lamp microscope examination, keratograph analysis, and Schirmer I test were measured at baseline, 1 week and 1 month postoperatively. RESULTS: In the BCL group, the score of the OSDI questionnaire was significantly decreased at 1 week and 1 month postoperatively compared with baseline levels (P = 0.000, collectively). Moreover, the fluorescein staining score of the BCL group was remarkably decreased 1-week and 1-month postoperatively compared with the non-BCL group (P = 0.000 and P = 0.000, respectively). Furthermore, the redness score of the BCL group was also better compared with the non-BCL group at 1 week and 1 month postoperatively (P = 0.014 and P = 0.004, respectively). CONCLUSIONS: Complicated cataract or/and IOL surgery would intensify the DED. Early application of BCLs postoperatively improved patients' comfort and alleviated dry eye-related symptoms and signs. Furthermore, this mechanism might involve the acceleration of corneal epithelial healing, the alleviation of ocular stress response and the stabilization of the tear film. TRIAL REGISTRATION: Trial registration ClinicalTrials, NCT04120389. Registered 10 October 2019-retrospectively registered.

Research progress on animal models of corneal epithelial-stromal injury.

A corneal epithelial-stromal defect is recognized as a major contributor to corneal scarring. Given the rising prevalence of blindness caused by corneal scarring, increasing attention has been focused on corneal epithelial-stromal defects. Currently, the etiology and pathogenesis of these defects remain inadequately understood, necessitating further investigation through experimental research. Various modeling methods exist both domestically and internationally, each with distinct adaptive conditions, advantages, and disadvantages. This review primarily aims to summarize the techniques used to establish optimal animal models of corneal epithelial-stromal injury, including mechanical modeling, chemical alkali burns, post-refractive surgery infections, and genetic engineering. The intention is to provide valuable insights for studying the mechanisms underlying corneal epithelial-stromal injury and the development of corresponding therapeutic interventions.

Prediction of postoperative visual acuity in patients with age-related cataracts using macular optical coherence tomography-based deep learning method.

Background: To predict postoperative visual acuity (VA) in patients with age-related cataracts using macular optical coherence tomography-based deep learning method. Methods: A total of 2,051 eyes from 2,051 patients with age-related cataracts were included. Preoperative optical coherence tomography (OCT) images and best-corrected visual acuity (BCVA) were collected. Five novel models (I, II, III, IV, and V) were proposed to predict postoperative BCVA. The dataset was randomly divided into a training (n = 1,231), validation (n = 410), and test set (n = 410). The performance of the models in predicting exact postoperative BCVA was evaluated using mean absolute error (MAE) and root mean square error (RMSE). The performance of the models in predicting whether postoperative BCVA was improved by at least two lines in the visual chart (0.2LogMAR) was evaluated using precision, sensitivity, accuracy, F1 and area under curve (AUC). Results: Model V containing preoperative OCT images with horizontal and vertical B-scans, macular morphological feature indices, and preoperative BCVA had a better performance in predicting postoperative VA, with the lowest MAE (0.1250 and 0.1194LogMAR) and RMSE (0.2284 and 0.2362LogMAR), and the highest precision (90.7% and 91.7%), sensitivity (93.4% and 93.8%), accuracy (88% and 89%), F1 (92% and 92.7%) and AUCs (0.856 and 0.854) in the validation and test datasets, respectively. Conclusion: The model had a good performance in predicting postoperative VA, when the input information contained preoperative OCT scans, macular morphological feature indices, and preoperative BCVA. The preoperative BCVA and macular OCT indices were of great significance in predicting postoperative VA in patients with age-related cataracts.

Effect of two different preoperative calculation schemes on visual outcomes of patients after toric intraocular lens implantation.

PURPOSE: To compare the postoperative visual outcomes of two different preoperative corneal incision schemes in TECNIS toric intraocular lens (IOL) implantation. METHODS: In this randomized controlled study, patients with preoperative corneal astigmatism greater than 1.0 diopter (D) were included. These patients were grouped according to the different preoperative schemes: steep-axis group and minimum-residual refractive astigmatism group. The outcome measurements were the residual refractive astigmatism, visual acuity, changes of corneal astigmatism, and high-order aberration at 1 month postoperatively. RESULTS: This study consisted of 90 eyes (45 eyes steep-axis group, 45 eyes minimum-residual refractive astigmatism group). 1 month after surgery, the refractive astigmatism was statistically lower in the minimum-residual refractive astigmatism group compared with the steep-axis group (0.58 ± 0.40D vs 0.38 ± 0.37D, P = 0.021). The minimum-residual refractive astigmatism group had a smaller difference vector (0.56 ± 0.38D vs 0.36 ± 0.35D; P = 0.047) and a smaller prediction error (0.60 ± 0.44D vs 0.37 ± 0.35D; P = 0.004). In the steep-axis group, corneal astigmatism significantly decreased compared with preoperative value (1.65 ± 0.57D vs 1.17 ± 0.64D; P < 0.001). In the minimum-residual refractive astigmatism group, the changes of corneal astigmatism before and after surgery were not significant. Moreover, total aberration and second astigmatism in ocular aberration were lower in the minimum-residual refractive astigmatism group compared with the steep-axis group (1.86 ± 1.09 vs 1.37 ± 0.95; P = 0.035 and 0.47 ± 0.28 vs 0.31 ± 0.19; P = 0.015, respectively). CONCLUSION: Minimum-residual refractive astigmatism incision had better astigmatism correction and more accurate prediction. The corneal astigmatism was stable 1 month after surgery. It might lead to better visual quality in the early postoperative stage. Trial registration number for prospectively registered trials: clinicaltrials.gov NCT04006912, 07/02/2019.

Efficacy of scleral-fixated 3-looped haptics intraocular lens implantation for surgical management of microspherophakia.

AIM: To evaluate the safety and efficacy of scleral-fixated 3-looped haptics intraocular lens (IOL) implantation for surgical management of microspherophakia. METHODS: A retrospective case series include 10 microspherophakic patients (15 eyes) who underwent lens removal plus a modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation. The primary outcomes involved visual acuity, intraocular pressure (IOP). Secondary outcomes were spherical equivalent (SE), anterior chamber depth (ACD), corneal endothelial cell density and postoperative complications. RESULTS: After a postoperative follow-up of 17.60±15.44mo, improved visual outcomes can be observed. The uncorrected distance visual acuity (UCVA) logMAR improved from 1.54±0.59 preoperatively to 0.51±0.35 postoperatively (P=0.001), and best corrected visual acuity (BCVA) logMAR improved from 0.97±0.91 preoperatively to 0.24±0.23 postoperatively (P=0.003). Moreover, the SE decreased from -9.58±7.47D preoperatively to -0.65±2.21 D postoperatively (P<0.001). In terms of safety profile, the average IOP decreased from 21.10±12.94 mm Hg preoperatively to 14.03±3.57 mm Hg postoperatively (P=0.044), and the previously elevated IOP of three eyes decreased to the normal range. The ACD increased from 2.25±1.45 mm preoperatively to 3.35±0.39 mm postoperatively (P=0.017). The density of corneal endothelial cells did not change significantly after surgery (P=0.140). The posterior chamber IOLs were well centered and no severe complications were found. CONCLUSION: Lens removal plus the modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation can help in improvement of visual acuity, which can be regarded as a relative safe method for the surgical management of microspherophakia.

Inhibition of Neovascularization and Inflammation in a Mouse Model of Corneal Alkali Burns Using Cationic Liposomal Tacrolimus.

Eye drops account for more than 90% of commercialized ophthalmic drugs. However, eye drops have certain shortcomings, such as short precorneal retention time and weak corneal penetration. The requirement of frequent instillation of eye drops also causes poor patient compliance, which may lead to further aggravation of the disease. We aimed to develop a cationic liposome formulation to increase the bioavailability of the therapeutic agent and solve the aforementioned problems. In the present study, we prepared cationic liposomal tacrolimus (FK506) with a surface potential of approximately +30 mV, which could bind to the negatively charged mucin layer of the ocular surface. Our results showed that the content of FK506 in the cornea was increased by 93.77, 120.30, 14.24, and 20.36 times at 5, 30, 60, and 90 min, respectively, in the FK506 liposome group (0.2 mg/ml) compared with the free drug group (0.2 mg/ml). Moreover, FITC-labeled FK506 liposomes significantly prolonged the ocular surface retention time to 50 min after a single dose. In addition, the results of the Cell Counting Kit-8 assay, live and dead cell assay, sodium fluorescein staining, and hematoxylin and eosin staining all indicated that FK506 liposomes had good biological compatibility in both human corneal epithelial cells and mouse eyeballs. Compared with the free drug at the same concentration, FK506 liposomes effectively inhibited vascular endothelial growth factor-induced green fluorescent protein-transduced human umbilical vein endothelial cell migration and tube formation in vitro. In a mouse corneal neovascularization model induced by alkali burns, FK506 liposomes (0.2 mg/ml) enhanced corneal epithelial recovery, inhibited corneal neovascularization, and reduced corneal inflammation, and its therapeutic effect was better than those of the commercial FK506 eye drops (1 mg/ml) and the free drug (0.2 mg/ml). Collectively, these results indicate that cationic FK506 liposomes could increase the efficacy of FK506 in the corneal neovascularization model. Therefore, cationic FK506 liposomes can be considered as a promising ocular drug delivery system.