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.

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.

Case series: "Double arch" changes caused by capsule contraction syndrome after cataract surgery in highly myopic eyes.

BACKGROUND: Capsule contraction syndrome (CCS) after cataract surgery causes intraocular lens (IOL) haptic flexion and IOL optic displacement in most former reports. However, there are few reports on CCS-induced deformation of the IOL optic. We report two cases of CCS after cataract surgery in highly myopic eyes and describe a previously unreported "double arch" complication. CASE PRESENTATION: Two patients with history of high myopia had cataract surgery with hydrophilic acrylic plate haptic IOLs implanted in their eyes. CCS with arch shape deformation of the pupil as well as the optic of the IOL were noticed in both cases after three months, which induced refractive changes and corrected distance visual acuity (CDVA) deterioration. Visual acuity of the patients was restored by replacing the IOL from the capsular bag to the ciliary sulcus and the following neodymium: YAG (Nd:YAG) laser capsulotomy. We propose that such "double arch" change brought by CCS is related to the plate-haptic design of the IOL and the incomplete overlap between the capsular opening and the IOL optic. CONCLUSIONS: We recommend careful IOL selection and proper capsulorhexis in patients with high myopia or with other risk factors of CCS. Early diagnosis and timely treatment of CCS are critical to prevent visual symptoms and further ocular complications.

[Analysis of TGFBI gene mutation in a Chinese pedigree affected with lattice corneal dystrophy].

OBJECTIVE: To explore the clinical features and mutation of TGFBI gene in a Chinese pedigree affected with lattice corneal dystrophy (LCD). METHODS: Genomic DNA was extracted from 35 members including 11 patients from the pedigree. The 17 exons and splicing region of introns of the TGFBI gene were amplified by PCR. The products were directly sequenced and compared with GenBank database to identify potential mutation. Bioinformatic analysis was carried out to predict the effect of mutation on proteins. RESULTS: A heterozygous mutation (p.R124C) was found in exon 4 of the TGFBI gene in all patients from the pedigree but not among unaffected members. The mode of inheritance of corneal dystrophy in this pedigree was identified as autosomal dominant. Bioinformatics analysis predicted that the p.R124C mutation may be functionally deleterious. The phenotype of corneal dystrophy in the pedigree was determined to be LCD I type. CONCLUSION: The p.R124C mutation of the TGFBI gene probably underlies the pathogenesis of LCD in this Chinese pedigree. Genetic testing can facilitate proper diagnosis of this type of corneal dystrophy.

[Analysis of TGFBI gene mutation in a Chinese family affected with Reis-Bucklers corneal dystrophy].

OBJECTIVE: To analyze the clinical features and TGFBI gene mutation in a Chinese family affected with Reis-Bucklers corneal dystrophy. METHODS: Genomic DNA was extracted from 53 members including 9 patients from the family. The 17 exons and splice region of introns of the TGFBI gene were amplified by PCR and directly sequenced. All family members were subjected to ophthalmologic examination. RESULTS: A heterozygous mutation (R124L) was found in exon 4 of the TGFBI gene among all patients from the family. The same mutation was not found among unaffected family members. The inheritance pattern of the family was identified as autosomal dominant, and the Reis-Bucklers corneal dystrophy in the family was diagnosed as the geographic type. CONCLUSION: The R124L mutation of the TGFBI gene probably underlies the pathogenesis of Reis-Bucklers corneal dystrophy in this Chinese family. Molecular genetic approach is useful for the proper diagnosis of this type of corneal dystrophy.

Application of capsular bag relaxation for capsular contraction syndrome.

The present study analyzed the surgical method and clinical effects of capsular bag relaxation surgery (CBRS) for the treatment of capsular contraction syndrome (CCS), which usually occurs post-phacoemulsification. The retrospective case study comprised of a total of 25 patients (25 eyes) who developed CCS after phacoemulsification and subsequently underwent CBRS. Among these patients, 15 patients (15 eyes) received actinoid relaxing incisions and 10 patients (10 eyes) underwent a second continuous curvilinear capsulorhexis. Postoperative naked-eye visual acuity was determined and compared with preoperative naked-eye visual acuity. Size changes of the transparent zone of the anterior capsule opening were observed under a slit lamp, as well as the anterior and posterior capsular membrane conditions and position of the intraocular lens (IOL). In addition, the presence of any subjective symptom, including glare or monocular diplopia, was investigated. A final 6-month postoperative follow-up was conducted for each patient. Visual acuity of all operated eyes improved to various extents. Notably, glare and monocular diplopia were no longer evident and patients could observe things clearly. Visual differences pre- and post-surgery were statistically significant (u=5.143, P<0.01). In addition, capsular bag shrinkage and relaxation were revealed under a slit lamp, the area of the transparent zone of the anterior capsule opening was expanded and the IOL remained centered. To conclude, CBRS is an effective treatment method for patients with CCS who are not suitable to receive laser treatment.

Adsorption of 5-sodiosulfoisophthalic acids from aqueous solution onto poly(2-vinylpyridine) resin.

In the present study, the performance, behavior and mechanism of synthetic poly(2-vinylpyridine) resin (WH-225) adsorbing 5-sodiosulfoisophthalic acids (SIPA) from the aqueous solution were investigated, and two commercial adsorbents, namely, hypercrosslinked adsorbent NDA-100 and macroporous adsorbent XAD-4 were employed as reference. Compared to NDA-100 and XAD-4, WH-225 has the highest capacity for adsorbing SIPA from the aqueous solution, which is verified by the related adsorption experiments. The investigation indicated that electrostatic interaction is an important factor in affecting the adsorption behavior of WH-225. The Freundlich isotherm equation was successfully applied to describe the adsorption isotherms. The negative values of the adsorptive enthalpy changes indicate an exothermic process for WH-225, and the absolute values (<43 kJ mol(-1)) further manifest a physical adsorption process. The column adsorption and desorption tests further proved WH-225 is a promising adsorbent for field applications to remove and recover aromatic acids (e.g. SIPA) from aqueous solution.