Influence of decentration of plate-haptic toric intraocular lens on postoperative visual quality.

BACKGROUND: To evaluate the influence of decentration of plate-haptic toric intraocular lens (IOLs) on visual quality. METHODS: This study enrolled 78 eyes of 78 patients. Patients in group A were implanted with toric IOLs, and patients in group B were implanted with monofocal IOLs. All patients were divided into group A1 and B1 (decentration below 0.3 mm) and group A2 and B2 (decentration above 0.3 mm). The uncorrected distance visual acuity (UDVA), best corrected visual acuity (BCVA), modulation transfer function cutoff (MTF cutoff), objective scatter index (OSI), strehl ratio (SR), optical interference and patients' satisfaction were measured in different pupils at three months postoperatively. The associations between decentration and visual quality were analyzed by Spearman correlation. RESULTS: There were no significant differences in UDVA, BCVA, MTF cutoff, OSI, SR, optical interference and patients' satisfaction among subgroups. The differences in decentration between groups A and B were not statistically significant. In group A2, the total higher order aberrations (tHOAs) at pupil sizes of 3 mm (P = 0.046), 5 mm (P = 0.014), spherical aberrations at pupil sizes of 3 mm (P = 0.011), 4 mm (P = 0.014), 5 mm (P = 0.000), secondary astigmatism at pupil sizes of 3 mm (P = 0.002), 4 mm (P = 0.005) were higher than in group B2. Compared to group A1, group A2 had higher spherical aberrations at pupil sizes of 4 mm (P = 0.042), 5 mm (P = 0.001), 6 mm (P = 0.038), secondary astigmatism at pupil sizes of 3 mm (P = 0.013), 4 mm (P = 0.005), 6 mm (P = 0.013). Group B2 has higher coma and secondary astigmatism than group B1 at 6-mm pupil (P = 0.014, P = 0.045). Significant positive correlations were found between spherical aberrations and the decentration of group A1 and A2 at 6-mm pupils. CONCLUSION: The decentration above 0.3 mm negatively affected visual quality due to increased tHOAs, spherical aberrations, coma and secondary astigmatism aberrations, the influence become larger with increasing pupil diameter. And toric IOLs are more affected by decentration than monofocal IOLs.

Counting Point Defects at Nanoparticle Surfaces by Electron Holography.

Metal oxide nanoparticles exhibit outstanding catalytic properties, believed to be related to the presence of oxygen vacancies at the particle's surface. However, little quantitative information is known about concentrations of point defects inside and at surfaces of these nanoparticles, due to the challenges in achieving an atomically resolved experimental access. By employing off-axis electron holography, we demonstrate, using MgO nanoparticles as an example, a methodology that discriminates between mobile charge induced by electron beam irradiation and immobile charge associated with deep traps induced by point defects as well as distinguishes between bulk and surface point defects. Counting the immobile charge provides a quantification of the concentration of F2+ centers induced by oxygen vacancies at the MgO nanocube surfaces.

An artificial intelligence approach to classify pathogenic fungal genera of fungal keratitis using corneal confocal microscopy images.

PURPOSE: Fungal keratitis is a common cause of blindness worldwide. Timely identification of the causative fungal genera is essential for clinical management. In vivo confocal microscopy (IVCM) provides useful information on pathogenic genera. This study attempted to apply deep learning (DL) to establish an automated method to identify pathogenic fungal genera using IVCM images. METHODS: Deep learning networks were trained, validated, and tested using a data set of 3364 IVCM images that collected from 100 eyes of 100 patients with culture-proven filamentous fungal keratitis. Two transfer learning approaches were investigated: one was a combined framework that extracted features by a DL network and adopted decision tree (DT) as a classifier; another was a complete supervised DL model which used DL-based fully connected layers to implement the classification. RESULTS: The DL classifier model revealed better performance compared with the DT classifier model in an independent testing set. The DL classifier model showed an area under the receiver operating characteristic curves (AUC) of 0.887 with an accuracy of 0.817, sensitivity of 0.791, specificity of 0.831, G-mean of 0.811, and F1 score of 0.749 in identifying Fusarium, and achieved an AUC of 0.827 with an accuracy of 0.757, sensitivity of 0.756, specificity of 0.759, G-mean of 0.757, and F1 score of 0.716 in identifying Aspergillus. CONCLUSION: The DL model can classify Fusarium and Aspergillus by learning effective features in IVCM images automatically. The automated IVCM image analysis suggests a noninvasive identification of Fusarium and Aspergillus with clear potential application in early diagnosis and management of fungal keratitis.

Multilayered Ceramic Membrane with Ion Conducting Thin Layer Induced by Interface Reaction for Stable Hydrogen Production.

Conventional methods for fabricating multilayered ceramic membranes with ion conducting dense thin layers are often cumbersome, costly, and limited by poor adhesion between layers. Inspired by the architectural structure of the rooted grasses in soil, here, we report an interface-reaction-induced reassembly approach for the direct fabrication of Ce0.9 Gd0.1 O2-δ (CGO) thin layers rooted in the parent multilayered ceramic membranes by only one firing step. The CGO dense layers are very thin, and adhered strongly to the parent support layer, ensuring low ionic transport resistance and structural integrity of the multilayered membranes. When using as an oxygen permeable membrane for upgrading fossil-fuel-derived hydrogen, it shows very long durability in harsh conditions containing H2 O, CH4 , H2 , CO2 and H2 S. Furthermore, our approach is highly scalable and applicable to a wide variety of ion conducting thin layers, including Y0.08 Zr0.92 O2-δ , Ce0.9 Sm0.1 O2-δ and Ce0.9 Pr0.1 O2-δ .

Electrostatic Shaping of Magnetic Transition Regions in La_{0.7}Sr_{0.3}MnO_{3}.

We report a magnetic transition region in La_{0.7}Sr_{0.3}MnO_{3} with gradually changing magnitude of magnetization, but no rotation, stable at all temperatures below T_{C}. Spatially resolved magnetization, composition and Mn valence data reveal that the magnetic transition region is induced by a subtle Mn composition change, leading to charge transfer at the interface due to carrier diffusion and drift. The electrostatic shaping of the magnetic transition region is mediated by the Mn valence, which affects both magnetization by Mn^{3+}-Mn^{4+} double exchange interaction and free carrier concentration.

Cavin-1 promotes M2 macrophages/microglia polarization via SOCS3.

PURPOSE: Our study aimed to investigate the function of Cavin-1 and SOCS3 in macrophages/microglia M2 polarization and further explored the relevant mechanism. METHODS: Expression levels of Cavin-1 and SOCS3 in macrophages/microglia were measured by western blotting and RT-PCR, respectively. Then, Cavin-1 or SOCS3 was gene silenced by a siRNA approach, and gene silencing efficiency was determined by western blotting. Next, co-immunoprecipitation (Co-IP) was employed to further analyze the interaction between Cavin-1 and SOCS3. Finally, the activation of STAT6/PPAR-γ signaling was evaluated using western blotting, and the M2 macrophages/microglia polarization was validated by measuring the mRNA expression of M2 markers by RT-PCR. RESULTS: In the polarization process of macrophages/microglia to M2 phenotype, both Cavin-1 and SOCS3 increased synchronously at protein and mRNA level, reached the peak at the 6 h, and then decreased. After Cavin-1 or SOCS3 silencing, the expression of Cavin-1 and SOCS3 declined. These results suggested that Cavin-1 and SOCS3 were positively correlated in macrophages/microglia, and this conjecture was verified by Co-IP. Besides, Cavin-1 silencing not only suppressed the activation of STAT6/PPAR-γ pathway, but also suppressed the release of anti-inflammatory factors. Finally, we found that SOCS3 overexpression reversed the inhibitory effect of Cavin-1 silencing on the release of anti-inflammatory factors in M2 macrophages/microglia. CONCLUSIONS: Cavin-1 and SOCS3 are actively involved in the process of M2 macrophages/microglia polarization. As a SOCS3 interacting protein, Cavin-1 can promote M2 macrophages/microglia polarization via SOCS3.

Binocular visual function after unilateral versus bilateral implantation of segmented refractive multifocal intraocular lenses: a pilot study.

PURPOSE: To evaluate binocular visual function after unilateral and bilateral implantation of segmented refractive multifocal intraocular lenses (MIOLs). METHODS: This prospective comparative pilot study included patients who underwent SBL-3 (Lenstec; + 3.00 D) implantation at Peking University Third Hospital. Patients were divided into two groups (monocular or binocular surgery). Thirty-two patients with emmetropic presbyopic contralateral eyes and 49 patients with bilateral SBL-3 implantation within a week between eyes were included in the unilateral SBL-3 and bilateral groups, respectively. At 3-month follow-up, the main outcomes were binocular uncorrected distant, intermediate, and near visual acuity (UDVA, UIVA, and UNVA). Secondary outcomes included binocular best-corrected visual acuity at all distances, defocus curve, contrast sensitivity, photic phenomena, spectacle independence, patient satisfaction, and National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) score. The essential perceptual phenomena constituting binocular vision, simultaneous perception, fusion, and stereopsis were also evaluated. RESULTS: Both groups showed similar binocular UDVA and UIVA, but UNVA was significantly better in the bilateral group (0.07 ± 0.07 versus 0.12 ± 0.07, P = 0.008). Better binocular defocus curve at intermediate to near focal points, higher percentage of spectacle independence at near distance, and NEI-VFQ-25 near activity scores were observed in the bilateral group. No significant differences in contrast sensitivity, photic phenomena, overall satisfaction, other NEI-VFQ-25 subscales, fusional amplitude, and stereoacuity were found between groups. CONCLUSION: Unilateral implantation of segmented refractive MIOL provided desirable distant visual acuity and high patient satisfaction, but inferior intermediate and near visual outcomes compared with bilateral implantation.

Comparison of visual outcomes of a diffractive trifocal intraocular lens and a refractive bifocal intraocular lens in eyes with axial myopia: a prospective cohort study.

BACKGROUND: To assess and compare the efficacy, safety, accuracy, predictability and visual quality of a diffractive trifocal intraocular lens (IOL) and a refractive rotationally asymmetric bifocal IOL in eyes with axial myopia. METHODS: This prospective cohort study enrolled patients with implantation of the diffractive trifocal IOL or the refractive bifocal IOL. Eyes were divided into four groups according to the IOL implanted and axial length. Manifest refraction, uncorrected and corrected visual acuity at far, intermediate and near distances, prediction error of spherical equivalent (SE), contrast sensitivity and aberrations were evaluated three months after surgery. RESULTS: In total, 80 eyes of 80 patients were included: 20 eyes in each group. Three months postoperatively, the corrected distance visual acuity of two trifocal groups were significantly better than the axial myopia bifocal group (P = 0.007 and 0.043). There was no significant difference of postoperative SE (P = 0.478), but the SE predictability of the trifocal IOL was better, whether in axial myopia groups (P = 0.015) or in control groups (P = 0.027). The contrast sensitivity was similar among four groups. The total aberration, higher order aberration and trefoil aberration of bifocal groups were significantly higher (all P < 0.001). CONCLUSIONS: The diffractive trifocal IOL and the refractive bifocal IOL both provided good efficacy, accuracy, predictability and safety for eyes with axial myopia. By contrast, the trifocal IOL had a better performance in corrected distance visual acuity and visual quality. TRIAL REGISTRATION: The study was retrospectively registered and posted on clinicaltrials.gov at 12/02/2020 (NCT04265846).

Nanomeshes with Sub-10 nm Pores by Glycerol-Triggered 2D Assembly in Liquid Phases for Fast and Selective Membranes.

Nanomeshes having ultrathin thicknesses and penetrating nanopores promise fast diffusion and precise selectivity and are highly desired in diffusion-involved processes such as separation. Herein, we report a liquid-phase two-dimensional (2D) assembly strategy to synthesize phenolic and carbonaceous nanomeshes with sub-10 nm pores and thicknesses. The synthesis is enabled simply by introducing glycerol in the thermopolymerization of resol/polyether micelles dispersed in ethanol. Experimental and simulation results reveal that glycerol's strong ability to form hydrogen bonds constrain the motion of the micelles, directing them to pack and merge exclusively in the lateral direction. Upon removal of polyether, we obtain phenolic nanomeshes with lateral sizes up to hundreds of micrometers, which can be further converted to carbonaceous nanomeshes. As a proof of concept, we use stacked phenolic and carbonaceous nanomeshes as separation membranes. They show superior permselectivity to nanosized solutes with permeance ∼2-110 times higher than that of other membranes.

Chemically Laminating Graphene Oxide Nanosheets with Phenolic Nanomeshes for Robust Membranes with Fast Desalination.

Graphene oxide (GO) is receiving tremendous attention in membrane separation; however, its desalination performances remain suboptimal because of excessive swelling and tortuous transport pathways. Herein, we chemically joint GO nanosheets and phenolic nanomeshes together to form laminated membranes comprising through-plane nanopores and stabilized nanochannels. GO and phenolic/polyether nanosheets are mixed to form stacked structures and then treated in H2SO4 to remove polyether to produce nanomeshes and to chemically joint GO with phenolic nanomeshes. Thus-synthesized laminated membranes possess enhanced interlayer interactions and narrowed interlayer spacings down to 6.4 Å. They exhibit water permeance up to 165.6 L/(m2 h bar) and Na2SO4 rejection of 97%, outperforming most GO-based membranes reported so far. Moreover, the membranes are exceptionally stable in water because the chemically jointed laminates suppress the swelling of GO. This work reports hybrid laminated structures of GO and phenolic nanomeshes, which are highly desired in desalination and other applications.

Fasudil attenuates glial cell-mediated neuroinflammation via ERK1/2 and AKT signaling pathways after optic nerve crush.

To investigate the functional role of fasudil in optic nerve crush (ONC), and further explore its possible molecular mechanism. After ONC injury, the rats were injected intraperitoneally either with fasudil or normal saline once a day until euthanized. RGCs survival was assessed by retrograde labeling with FluoroGold. Retinal glial cells activation and population changes (GFAP, iba-1) were measured by immunofluorescence. The expressions of cleaved caspase 3 and 9, p-ERK1/2 and p-AKT were detected by western blot. The levels of the pro-inflammatory cytokines were determined using real-time polymerase chain reaction. Fasudil treatment inhibited RGCs apoptosis and reduced RGCs loss demonstrated by the decreased apoptosis-associated proteins expression and the increased fluorogold labeling of RGCs after ONC, respectively. In addition, the ONC + fasudil group compared had a significantly lower expression of GFAP and iba1 compared with the ONC group. The levels of pro-inflammatory cytokines were significantly reduced in the ONC + fasudil group than in the ONC group. Furthermore, the phosphorylation levels of ERK1/2 and AKT (p-ERK1/2 and p-AKT) were obviously elevated by the fasudil treatment. Our study demonstrated that fasudil attenuated glial cell-mediated neuroinflammation by up-regulating the ERK1/2 and AKT signaling pathways in rats ONC models. We conclude that fasudil may be a novel treatment for traumatic optic neuropathy.

Room-Temperature Spin-Orbit Torque from Topological Surface States.

Spin-momentum locked surface states in topological insulators (TIs) provide a promising route for achieving high spin-orbit torque (SOT) efficiency beyond the bulk spin-orbit coupling in heavy metals (HMs). However, in previous works, there is a huge discrepancy among the quantitative SOTs from TIs in various systems determined by different methods. Here, we systematically study the SOT in the TI(HM)/Ti/CoFeB/MgO systems by the same method, and make a conclusive assessment of SOT efficiency for TIs and HMs. Our results demonstrate that TIs show more than one order of magnitude higher SOT efficiency than HMs even at room temperature, at the same time the switching current density as low as 5.2×10^{5} A cm^{-2} is achieved with (Bi_{1-x}Sb_{x})_{2}Te_{3}. Furthermore, we investigate the relationship between SOT efficiency and the position of Fermi level in (Bi_{1-x}Sb_{x})_{2}Te_{3}, where the SOT efficiency is significantly enhanced near the Dirac point, with the most insulating bulk and conducting surface states, indicating the dominating SOT contribution from topological surface states. This work unambiguously demonstrates the ultrahigh SOT efficiency from topological surface states.

Two Kinds of Metastable Structures in an Epitaxial Lanthanum Cobalt Oxide Thin Film.

Thin films have attracted much interest because they often have novel properties different from those of their bulk counterparts. In this work, we tune two metastable states in three kinds of lanthanum cobalt oxide thin films by electron beam irradiation and record their dynamic transition process in situ in a transmission electron microscope. The lanthanum cobalt oxide thin films exhibit a homogeneous microstructure in the initial state and then transfer to a stripelike superstructure with 3a0 periodicity (a0 is the perovskite lattice parameter), further developing into a superstructure with 2a0 periodicity in dark stripes (brownmillerite structure). To explore the inherent energy discrepancy within the two metastable states, we perform first-principles calculations on a LaCoO3-δ (0 ≤ δ ≤ 0.5) thin film system by geometry optimization. The calculation results suggest that the forming energy of the 3a0 periodicity stripelike structure is a little lower than that of the 2a0 periodicity in the LaCoO3-δ thin film. Our work explains why the two stripelike structures coexist in lanthanum cobalt oxide thin films and extends prospective applications related to oxygen vacancies in thin films.

Nanoscale characterization of 1D Sn-3.5Ag nanosolders and their application into nanowelding at the nanoscale.

One-dimensional Sn-3.5Ag alloy nanosolders have been successfully fabricated by a dc electrodeposition technique into nanoporous templates, and their soldering quality has been demonstrated in nanoscale electrical welding for the first time, which indicates that they can easily form remarkably reliable conductive joints. The electrical measurement shows that individual 1D Sn-3.5Ag nanosolders have a resistivity of 28.9 µΩ·cm. The morphology, crystal structure and chemistry of these nanosolders have been characterized at the nanoscale. It is found that individual 1D Sn-3.5Ag alloy nanosolders have a continuous morphology and smooth surface. XPS confirms the presence of tin and silver with a mass ratio of 96.54:3.46, and EDX elemental mappings clearly reveal that the Sn and Ag elements have a uniform distribution. Coveragent beam electron diffractions verify that the crystal phases of individual 1D Sn-3.5Ag alloy nanosolders consist of matrix ß-Sn and the intermetallic compound Ag3Sn. The reflow experiments reveal that the eutectic composition of the 1D Sn-Ag alloy nanowire is shifted to the Sn rich corner. This work may contribute one of the most important tin-based alloy nanosolders for future nanoscale welding techniques, which are believed to have broad applications in nanotechnology and the future nano-industry.

Prolonged Button Battery Exposure Leading to Severe Ocular Injury without Heavy Metal Poisoning.

Introduction: Prolonged exposure to a complete button battery can cause severe tissue necrosis in the eye and permanent impairment of visual function. The main mechanism of injury is the current generated by the hydrolysis of tissue fluid at the negative electrode and the production of hydroxide ions. Case Presentation: A 3-year-old girl went to the local hospital because of swelling and pain in her right eye of 12-h duration. The local doctor performed an orbital CT (computed tomography) scan and found a foreign body between the right eyelid and the eyeball. The foreign body was removed immediately under general anesthesia. In addition, it was found that the foreign body was a button battery, but it prolonged 39 h from the onset of the child's symptoms. The child underwent a second operation in our hospital and received amniotic membrane transplantation combined with conjunctival flap coverage. Topical corticosteroid and antibiotic eye ointment were continued for 3 months after surgery. Local pigmentation was seen, there was no symblepharon, but the cornea was still opaque and the visual acuity was only FC (finger count). In this particular case, heavy metal testing conducted on the child's blood fortunately revealed that the levels were within the normal range. Conclusion: Early detection and urgent removal of button battery are crucial in order to minimize exposure time. We should also be concerned about heavy metals in the blood. Children should be kept away from button batteries as much as possible to avoid such injury.

Ucf-101 alleviates Ischaemia/Reperfusion induced retinal inflammation and injury via suppressing oxidative damage.

The Omi/HtrA2 inhibitor 5-[5-(2-nitrophenyl) furfuryliodine]-1,3-diphenyl-2-thiobarbituric acid (Ucf-101) has shown neuroprotective effects in the central nervous system. However, whether Ucf-101 can protect retinal ganglion cells (RGCs) after retinal ischemia/reperfusion (IR) has not been investigated. We aimed to investigate the effects of Ucf-101 on RGCs apoptosis and inflammation after IR-induced retinal injury in mice. We injected Ucf-101 into the mouse vitreous body immediately after IR injury. After 7 days, hematoxylin and eosin staining was conducted to assess retinal tissue damage. Next, retrograde labeling with FluoroGold, counting of RGCs and TUNEL staining were conducted to evaluate apoptosis. Immunohistochemistry, immunofluorescence staining, and western blotting were conducted to analyze protein levels. IR injury-induced retinal tissue damage could be prevented by Ucf-101 treatment. The number of TUNEL-positive RGCs was reduced by Ucf-101 treatment in mice with IR injury. Ucf-101 treatment inhibited the upregulation of Bax, cleaved caspase-3 and cleaved caspase-9 and activated the JNK/ERK/P38 signaling pathway. Furthermore, Ucf-101 treatment inhibited the upregulation of glial fibrillary acidic protein (GFAP), vimentin, Iba1 and CD68 in mice with IR injury. Ucf-101 prevents retinal tissue damage, improves the survival of RGCs, and suppresses microglial overactivation after IR injury. Ucf-101 might be a potential target to prevent RGCs apoptosis and inflammation in neurodegenerative eye diseases.

Selenium nanomaterials improve the quality of lettuce (Lactuca sativa L.) by modulating root growth, nutrient availability, and photosynthesis.

Macro- or micro-nutrients are essential for crop yield and nutritional quality. In this work, selenium engineering nanomaterials (Se ENMs, 0.5 mg‧kg-1) significantly increased the yield and nutritional quality of lettuce, which was better than that of selenite (Na2SeO3). Under the treatment of Se ENMs, macro-nutrients including nitrogen (N), phosphorus (P), potassium (K), calcium (Ca), and magnesium (Mg) were increased by 15.8%, 98.5%, 42.8%, 146.9%, and 62.5%, respectively, and micro-nutrients including manganese (Mn), iron (Fe), copper (Cu), and zinc (Zn) were also increased by 87.4%, 78.0%, 61.1%, and 56.1%, respectively. As a result, the improved nutritional status of lettuce leaves increased photosynthesis (59.2%) and yield (37.6%). Root diameters and root tips of lettuce were increased by 23.9% and 18.6%, respectively, upon exposure to Se ENMs, which may be responsible for facilitating the absorption of macro and micro nutrients from the soil. These effects were significantly better than SeO32- treated group. Metabolome results indicated that Se ENMs could improve the shikimic acid, phenylalanine, and tyrosine pathway, resulting in an enhancement of the beneficial compounds, including quercetin, rutin, and coumarin, by 2.9, 2.7, and 2.4-fold, respectively. Besides, pyruvic acid and TCA cycle were also improved by Se ENMs. These results provide new insight into the positive effect of Se ENMs on crop yield and nutritional quality, which demonstrate that the Se ENMs-enabled agriculture practices have a promising prospect as a sustainable crop strategy.

A Hybrid System for Automatic Identification of Corneal Layers on In Vivo Confocal Microscopy Images.

Purpose: Accurate identification of corneal layers with in vivo confocal microscopy (IVCM) is essential for the correct assessment of corneal lesions. This project aims to obtain a reliable automated identification of corneal layers from IVCM images. Methods: A total of 7957 IVCM images were included for model training and testing. Scanning depth information and pixel information of IVCM images were used to build the classification system. Firstly, two base classifiers based on convolutional neural networks and K-nearest neighbors were constructed. Second, two hybrid strategies, namely weighted voting method and light gradient boosting machine (LightGBM) algorithm were used to fuse the results from the two base classifiers and obtain the final classification. Finally, the confidence of prediction results was stratified to help find out model errors. Results: Both two hybrid systems outperformed the two base classifiers. The weighted area under the curve, weighted precision, weighted recall, and weighted F1 score were 0.9841, 0.9096, 0.9145, and 0.9111 for weighted voting hybrid system, and were 0.9794, 0.9039, 0.9055, and 0.9034 for the light gradient boosting machine stacking hybrid system, respectively. More than one-half of the misclassified samples were found using the confidence stratification method. Conclusions: The proposed hybrid approach could effectively integrate the scanning depth and pixel information of IVCM images, allowing for the accurate identification of corneal layers for grossly normal IVCM images. The confidence stratification approach was useful to find out misclassification of the system. Translational Relevance: The proposed hybrid approach lays important groundwork for the automatic identification of the corneal layer for IVCM images.

Comparison of binocular visual quality in six treatment protocols for bilateral cataract surgery with presbyopia correction: a prospective two-center single-blinded cohort study.

OBJECTIVE: To compare the postoperative binocular visual quality in six treatment protocols for bilateral age-related cataract surgery with presbyopia correction for clinical decisions. MATERIALS AND METHODS: In this prospective two-center single-blinded cohort study, participants from North or South China who underwent bilateral phacoemulsification and intraocular lens implantation were divided into six protocols: monovision, diffractive bifocal, mixed, refractive bifocal, trifocal, and micro-monovision extended range of vision (EROV). Binocular visual quality was evaluated at 3 months postoperatively, including binocular uncorrected full-range visual acuity, binocular defocus curves (depth of focus [DoF] and area under the curve [AUC]), binocular visual function (fusion function and stereopsis), binocular subjective spectacle independence rates, visual analog scale (VAS) of overall satisfaction, 25-item visual function questionnaire (VFQ-25), and binocular dysphotopsia symptoms. RESULTS: Of the 300 enrolled patients, 272 (90.7%; 544 eyes) were analyzed. The trifocal protocol showed excellent binocular full-range visual acuity and the best performance for most DoFs and AUCs. The monovision protocol presented the worst binocular visual quality in most perspectives, especially in convergence, distance, and near stereopsis (p < 0.001). The full-range subjective spectacle independence rates were sorted from highest to lowest as follows: trifocal (84.8%), refractive bifocal (80.9%), EROV (80.0%), mixed (73.3%), diffractive bifocal (65.2%), and monovision (32.6%) protocols, with no statistically significant differences between the former five protocols (p > 0.05). The EROV protocol achieved the highest VAS and VFQ-25 scores. The incidence of postoperative binocular dysphotopsia symptoms was comparable in all protocols. CONCLUSIONS: The trifocal protocol showed the best performance, and the monovision protocol presented the worst performance in most perspectives of binocular visual quality for presbyopia correction. The refractive bifocal, mixed, or EROV protocols can provide an approximate performance as a trifocal protocol. Ophthalmologists can customize therapies using different protocols.

Inhibition of NOX4 with GLX351322 alleviates acute ocular hypertension-induced retinal inflammation and injury by suppressing ROS mediated redox-sensitive factors activation.

Reactive oxygen species (ROS) overproduction plays an essential role in the etiology of ischemic/hypoxic retinopathy caused by acute glaucoma. NADPH oxidase (NOX) 4 was discovered as one of the main sources of ROS in glaucoma. However, the role and potential mechanisms of NOX4 in acute glaucoma have not been fully elucidated. Therefore, the current study aims to investigate the NOX4 inhibitor GLX351322 that targets NOX4 inhibition in acute ocular hypertension (AOH)-induced retinal ischemia/hypoxia injury in mice. Herein, NOX4 was highly expressed in AOH retinas, particularly the retinal ganglion cell layer (GCL). Importantly, the NOX4 inhibitor GLX351322 reduced ROS overproduction, inhibited inflammatory factor release, suppressed glial cell activation and hyperplasia, inhibited leukocyte infiltration, reduced retinal cell senescence and apoptosis in damaged areas, reduced retinal degeneration and improved retinal function. This neuroprotective effect is at least partially associated with mediated redox-sensitive factor (HIF-1α, NF-κB, and MAPKs) pathways by NOX4-derived ROS overproduction. These results suggest that inhibition of NOX4 with GLX351322 attenuated AOH-induced retinal inflammation, cellular senescence, and apoptosis by inhibiting the activation of the redox-sensitive factor pathway mediated by ROS overproduction, thereby protecting retinal structure and function. Targeted inhibition of NOX4 is expected to be a new idea in the treatment of acute glaucoma.