To quantitate lens nuclear opacity using long-range swept-source optical coherence tomography (SS-OCT) images and to evaluate the correlation of this method to Lens Opacities Classification System ...III (LOCS III) and a Scheimpflug imaging-based grading system (Pentacam Nuclear Stage function; PNS).
This study enrolled 120 participants (120 eyes) with age-related nuclear cataracts. The best-corrected visual acuity (BCVA), LOCS III nuclear opalescence (NO) and nuclear colour (NC) were obtained. The nuclear density measured using PNS function (ND
) was recorded. Three successive series of long-range SS-OCT images were captured, and the nuclear region was analysed using ImageJ (NIH, Bethesda, Maryland, USA) to generate SS-OCT image-based nuclear density (ND
). The repeatability of ND
measurement was evaluated using within-subject coefficient of variation (CV
) and intraclass correlation coefficient (ICC). Correlations of ND
with NO and NC, BCVA and ND
were analysed. According to the integrity of nucleus imaged by Pentacam, patients were divided into two groups, and the parameters were compared between groups.
The CV
and ICC for ND
measurement were 1.5 % and 0.994, respectively. The ND
significantly correlated with NO (r=0.831), NC (r=0.873), BCVA (r=0.655) and ND
(r=0.891). The ND
, NO and NC, and BCVA were significantly different between the two groups.
Lens nuclear opacity quantitation using long-range SS-OCT images was repeatable and correlated well with LOCS III and PNS function. The Scheimpflug principle had a limitation in imaging dense nucleus. Long-range SS-OCT seems more promising for objectively and quantitatively assessing lens nuclear opacity.
Abstract
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.
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.
Background
To investigate the incidence of developing posterior vitreous detachment (PVD) in children after congenital cataract surgery.
Methods
This is a prospective study which recruited 131 ...children with congenital cataracts who underwent cataract surgery between June 1, 2015, and September 1, 2018. The patients were divided into two groups depending on their post-operation phakic status (with or without IOL implantation). Infants aged from 6 to 12 months from two groups were analyzed as subgroups, respectively. B-scan ultrasonography was performed before the procedure and at 1, 3, 6, 9, and 12-month follow-ups, respectively, after the operation.
Results
Of the 131 eyes included in the analyses, 74 were aphakic, and 57 were pseudophakic after surgery. The postoperative rate of PVD in all analyzed eyes was 6.9% (9 of 131 eyes). After 12 months, PVD was significantly more prevalent in the eyes that underwent cataract surgery with IOL implantation (10.5%, 6 of 57 eyes) compared to the eyes without IOL implantation (4.1%, 1 of 74 eyes,
P
< 0.05); however, the eyes in the aphakic group were significantly younger than the eyes in the pseudophakic group, while the mean axial length (AL) of the pseudophakic eyes (21.11 ± 2.07 mm) was significantly higher than that of the aphakic eyes (18.93 ± 1.86 mm) (
P
< 0.01). In patients between the ages of 6 and 12 months of age from the two groups, the AL of patients with IOL implantation continued to be significantly increased compared to the group without IOL implantation (20.44 ± 1.68 mm vs. 19.78 ± 1.52 mm,
P
< 0.01). At the follow-up appointments, two patients with PVD were observed among the 14 eyes that had undergone cataract surgery with IOL implantation, while one eye was observed to have developed PVD among the 15 eyes without IOL implantation.
Conclusions
PVD occurs with greater frequency after congenital cataract surgery, particularly in eyes that have undergone IOL implantation. We suggest that PVD should be carefully monitored in children after congenital cataract surgery to avoid subsequent ocular pathologies such as retinal detachment. Future studies are needed to determine other potential risk factors that have not been as thoroughly explored, as opposed to better-known factors such as older age, longer axial length, and IOL implantation.
Purpose
To develop a model for predicting postoperative axial length (AL) in children undergoing cataract surgery younger than 2 years of age.
Setting
The Eye Hospital of Wenzhou Medical University, ...Hangzhou, China
Design
Retrospective study.
Methods
Children were included only if AL data were available before surgery and at least 1 year after surgery. Eyes were divided into pseudophakic, aphakic, and unaffected eye groups. Variables that could influence axial growth were analyzed and a multivariable generalized estimating equation regression model was developed to predict postoperative AL.
Results
333 eyes from 190 patients were included. We observed a logarithmic linear correlation between age and AL in the unaffected eye group, AL = (2.7924 × log of age in months) + 17.607, R
2
= 0.6596. Meanwhile, The GEE model of eyes with cataracts can be written as follows:
Postoperative AL = 6.408 + 0.611 × (baseline AL) + 0.007 × (baseline age) − -0.006 (baseline age) × (age at follow-up) − -0.391 × coefficient of surgery. The ages were recorded in months, the ALs were recorded in millimeter.
Conclusions
The assessment of AL is one of the most important parts of successful postoperative management in congenital cataract patients. This study established an AL estimate formula for children aged ≤ 2 years with congenital cataract who underwent cataract surgery. This model theoretically could be used to predict individual future AL for child undergoing cataract surgery.
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.
To assess the influence of angle kappa (κ) and angle alpha (α) on visual quality after multifocal intraocular lens (IOL) implantation.
Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ...China.
Prospective case series.
Patients with cataract had phacoemulsification with TECNIS Symfony IOL implantation. The preoperative angle κ and angle α were measured using the iTrace device. Distance, intermediate, and near visual acuities were recorded 3 months postoperatively. The Optical Quality Analyzing System was used to measure the objective scatter index (OSI), modulation transfer function (MTF) cutoff frequency, and Strehl ratio. A patient questionnaire was also administered.
The study comprised 29 patients (57 eyes). Monocularly, the mean postoperative logarithm of the minimum angle of resolution (logMAR) uncorrected distance, intermediate, and near visual acuities were 0.03 ± 0.09 (SD), 0.05 ± 0.11, and 0.11 ± 0.09, respectively. The mean postoperative logMAR corrected distance, distance-corrected intermediate, and distance-corrected near visual acuities were −0.01 ± 0.05, 0.04 ± 0.09, and 0.11 ± 0.08, respectively. The mean OSI, MTF cutoff, and Strehl ratio were 1.27 ± 0.84, 32.03 ± 10.80 cycles per degree, and 0.17 ± 0.05, respectively. The OSI (r = 0.398, P = .005), MTF (r = −0.437, P = .002), and Strehl ratio (r = −0.419, P = .003) values were significantly correlated with angle κ. There was no correlation with angle α.
Angle κ affected the objective visual quality multifocal after IOL implantation. The decision to implant a multifocal IOL should be carefully considered for patients with a large angle κ.
To explore the relationship between the change in intraocular lens (IOL) position and capsular bend after cataract surgery.
Patients underwent phacoemulsification and IOL implantation (Alcon ...Laboratories, Inc). Patients were divided into two groups based on preoperative axial length: long axial length group (axial length ⩾ 26 mm) and normal axial length group (axial length > 22 but < 26 mm). Swept-source optical coherence tomography was performed at 1 day, 1 week, 1 month, and 3 months after mydriasis to obtain postoperative aqueous depth (PAD) and capsular bend index (CBI). The relationship between CBI and PAD changes was analyzed.
Eighty patients (80 eyes) were included in the study. PAD decreased gradually from 1 day to 1 week and increased from 1 week to 3 months. Mean CBI was moderately positively correlated with PAD changes (
= 0.586,
< .001). The IOL moved forward gradually when the CBI was less than 2.30 and the IOL gradually moved backward when the CBI was 2.30 or greater. The root mean square of the change in PAD was smaller in the long axial length group (0.08 ± 0.04 mm) than in the normal axial length group (0.09 ± 0.05 mm) during the 3 months after surgery (
= .036).
The position of the IOL was almost stable 1 month after operation, and postoperative capsule adhesion mainly occurred within 1 month. The change in PAD was related to capsule adhesion. The postoperative position of the IOL was relatively stable and capsular bend was relatively slow for the long axial length group over 3 months.
.
Purpose
The objective of this was to determine the efficacy of different patterns of intense pulsed light (IPL) therapy in patients with meibomian gland dysfunction (MGD).
Materials and method
IPL ...treatment was administered in 124 eyes of 62 patients with MGD-associated dry eye disease (DED). These patients were divided randomly into two groups treated with different IPL patterns. The first group was treated with “Optimal Pulse Technology” (OPT) (
n
= 29) and received three consecutive treatments (10–14 J/cm
2
) with three weeks between treatments. The other group was treated with “Intense Regulated Pulsed Light” (IRPL) (
n
= 33) and received four treatments (9–13 J/cm
2
) on days (D)1, D15, D45, and D75. The Ocular Surface Disease Index (OSDI), fluorescein breakup time (FTBUT), first and the average of noninvasive keratograph tear breakup times (NIKBUT), Schirmer I tests, conjunctival hyperemia, corneal fluorescent staining (CFS), tear meniscus height (TMH), MG secretion, and dropout were examined before each treatment and at one and three months after treatment.
Results
Compared to baseline, the clinical symptoms and signs in both groups were significantly improved at one and three months after IPL treatment. However, compared to the IRPL group, the OPT-treated group showed significant improvement in the clarity of MG secretions (
P
= 0.001), the number of MGs yielding clear or cloudy liquid secretions (
P
< 0.001), the total MG secretion score (
P
< 0.001) in lower eyelid, the lid margin score in upper (
P
< 0.001) and lower eyelids (
P
= 0.013), the first NIKBUT (
P
= 0.009), and FTBUT (
P
= 0.006).
Conclusions
These results suggest that IPL has significant clinical value in treating patients with MGD. OPT IPL treatment was more effective in improving MG function in lower eyelids and partial tear film signs than IRPL IPL treatment.
Trial Registration
The study was registered at
www.clinicaltrials.gov
, and the clinical trial accession number is NCT02481167.
To evaluate the effect of intraocular lens (IOL) optic overlapping on IOL stability and to determine the relationship between the capsulorhexis and IOL movement with the three-dimensional method of ...swept-source optical coherence tomography (SS-OCT).
This study identified patients with age-related cataracts and divided them into two groups according to their anterior capsule and IOL optic relationship: total anterior capsule overlap (360°) and partial anterior capsule overlap (< 360°). Standard SS-OCT radial scanning was performed in all eyes at 1 day, 1 week, 1 month, and 3 months after cataract surgery, respectively. The obtained photographs were used for the postoperative position measurements of capsulorhexis and IOL after three-dimensional reconstruction.
This study included 46 eyes of 34 patients: total overlap group (n = 29) and partial overlap group (n = 17). The postoperative aqueous depth significantly decreased in the first week after surgery (P < .001). The IOL tilt was greater in the partial overlap group than that in the total overlap group (P = .014). The IOL moved significantly in the first week postoperatively (both P < .001). IOL decentration in the x-axis was greater in the partial overlap group than that in the total overlap group (P = .024). The IOL and capsulorhexis both moved sharply in the first week (both P < .05). The IOL moved consistently with the capsulorhexis in the 3 months after surgery (all P > .05).
The total overlap group showed better IOL centrality and stability. IOL movement may be driven by capsular bag contraction and fibrosis. Thus, it was demonstrated that postoperative IOL position and IOL performance were closely linked with proper size of central continuous curvilinear capsulorhexis. J Refract Surg. 2020;36(6):388-394..
