Application of femtosecond laser in assisted cataract after ICL implantation with different vault

Dear Editor,We are writing this letter to report two unusual cases of femtosecond laser-assisted cataract surgery(FLACS)in two ICL-implanted patients with significant different vault.FLACS has been confirmed by accumulating evidence to improve the safety and precision of surgery from common cases to complicated cases in treating cataracts[1-3].Implantable collamer lens(ICL)implantation possesses a good performance in its predictability,reversibility,and the rapid visual recovery.

Acute micro-macular hole associating with extensive intraoperative rotation of implantable collamer lens without ophthalmic viscosurgical device assistance:a case report

Dear Editor,We are writing this letter to report a micro-macular hole(mMH)following the intraoperative rotation of implantable collamer lens(ICL,V4c,Staar Surgical,Monrovia,CA,USA)without ophthalmic viscosurgical device(OVD)assistance and eventually this mMH closed spontaneously.

散光多焦点IOL植入术后视觉质量及患者满意度研究

目的:观察白内障超声乳化术后植入AT LISA Toric 909MP(909M)散光矫正型多焦点IOL和AT TORBI 709M(709M)散光矫正型单焦点IOL术后视觉质量及患者满意度。方法:选取2017-12/2018-12在本院行超声乳化IOL植入术合并散光大于1.0D的白内障患者40例56眼,根据患者自愿植入单焦点散光或多焦点散光IOL分为2组,909M组23例35眼,709M组17例21眼,术后随访3mo,观察术后两组视力恢复情况、离焦曲线、残余散光度数、晶状体旋转度、术后视觉质量分析及患者满意度。结果:治疗后两组的裸眼远视力及最佳矫正远视力较术前明显改善(P<0.05)。离焦曲线显示909M组在0D和-2.5D时有两个视力峰值,在-1D有一个低的峰值。709M组仅在0D有视力峰值。909M组脱镜率为91%(21/23),709M组的脱镜率仅为18%(3/17)。结论:多焦点和单焦点IOL对于白内障合并散光有良好的矫正效果,旋转稳定性良好,且多焦点IOL为患者提供了良好的远近视力以及可以接受的中视力,提高了患者的脱镜率和满意度。

Early outcomes of vision and objective visual quality analysis after cataract surgery with trifocal intraocular lens implantation

AIM: To investigate the early outcomes of vision, objective visual quality and their correlation after cataract surgery with trifocal intraocular lens implantation.METHODS: The visual examination and objective visual quality analysis using Optical Quality Analysis System(OQAS) at 1 mo and 3 mo, and defocus curve examination at 3 mo were performed in 20 patients(27 eyes) after phacoemulsification combined with trifocal intraocular lens implantation surgery.RESULTS: The uncorrected distant(UD), intermediate and near visual acuity(VA) were significantly improved after surgery(P<0.001). UDVA at 1 mo after the surgery was slightly better than that after 3 mo(P=0.026). The defocus curve after 3 mo indicated that the peak of distant vision was close to 0 logMAR, and UDVA was lower than 0.3 logMAR in the range of-1.5 D to-3.0 D. The modulation transfer function(MTF) cutoff frequency, strehl ratio(SR), Optical Quality Analysis System values(OVs), includes OV100, OV20 and OV9 after the surgery were significantly better than before surgery(P<0.001), but the objective scattering index(OSI) was significantly decreased(P<0.001). UDVA at 3 mo after the surgery had correlations with MTF cutoff, OSI, OV100 and OV20(r=-0.400, 0.431,-0.437,-0.411, P=0.039, 0.025, 0.023, 0.033). The uncorrected intermediate VA after 3 mo of the surgery had correlations with OSI and OV100(r=0.478,-0.411, P=0.012, 0.033). CONCLUSION: Trifocal intraocular lens implantation can provide good distant, intermediate and near VA, and the vision shows a well correlation with objective visual quality during early surgery.

Hydrophobic versus hydrophilic acrylic intraocular lens on posterior capsule opacification: a Meta-analysis

AIM: To conduct a Meta-analysis pooling randomized controlled trials(RCTs) to compare hydrophobic with hydrophilic acrylic intraocular lenses in terms of posterior capsule opacification(PCO) development.METHODS: Electronic databases including PubMed,Embase, and the Cochrane Library were queried from their starting till January 2020. RCTs investigating the impact of hydrophobic versus hydrophilic acrylic intraocular lenses on PCO were considered eligible in this study. The pooled effect estimates were calculated using the random-effects model.RESULTS: Thirteen RCTs comprising of 939 patients(1263 eyes) were covered in this study. Patients with hydrophobic acrylic intraocular lenses had a lower PCO score than those with a hydrophilic acrylic intraocular lenses [standard mean difference:-1.80;95% confidence interval(CI):-2.62 to-0.98;P<0.001]. Moreover, the frequency of neodymium-doped yttrium aluminum garnet(Nd:YAG)capsulotomy in patients with hydrophobic acrylic intraocular lenses was significantly lower than patients with hydrophilic acrylic intraocular lenses(relative risk: 0.38;95%CI: 0.20-0.71;P=0.003).CONCLUSION: These findings suggest that hydrophobic acrylic intraocular lenses are superior to hydrophilic acrylic intraocular lenses in patients after cataract surgery due to lower PCO score and reduced Nd:YAG capsulotomy. While similar studies are conducted by other researchers, the present study conducted subgroup analyses that show superior results with hydrophobic lenses in trials conducted in western countries.

Comparative analysis of visual quality between unilateral implantation of a trifocal intraocular lens and a rotationally asymmetric refractive multifocal intraocular lens

·AIM:To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens(IOL)and asymmetric refractive multifocal IOL.·METHODS:The prospective nonrandom,comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs:AT LISA tri 839 MP(30 eyes;Carl Zeiss Meditec,Germany)and LS-313 MF30(30 eyes;Oculentis GmbH,Germany).Visual acuity,refractive outcome,contrast sensitivity,defocus curves,quality of vision,and optical phenomena were evaluated at3 mo postoperatively.·RESULTS:There were no statistical differences between groups in uncorrected distance visual acuity(P=0.13)and uncorrected near visual acuity(P=0.54).In contrast,uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group(P=0.02).No significant statistical between-group difference was detected in cylinder(P=0.43).Compared to trifocal group,spherical refraction and spherical equivalent in refractive multi focal group were more myopic(P<0.01).Under photopic conditions,no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree(cpd).The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group(P=0.01,P=0.034,respectively).The questionnaires of quality of vision and optical phenomena showed no differences between groups.·CONCLUSION:Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity.Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.

Toric implantable collamer lens for the management of pseudophakic anisometropia and astigmatism

Dear Editor,We present the reported case of toric implantable collamer lens(ICL)implantation for correcting pseudophakic anisometropia after unilateral traumatic cataract surgery 10 years ago.After cataract surgery,the normal pattern of eye development is broken.

Analysis of candidate genes of QTL and chromosomal regions for essential hypertension in the rat model

This is an in silico analysis of quantitative trait loci (QTLs), genes, polymorphisms, and chromosomal regions regulating hypertension in the rat genome. Utilizing PGmapper, a program that matches phenoltypes to genes, we identified 266 essential hypertension-associated genes (HyperA), and 83 of these genes contain known hypertension-associated polymorphisms (HyperAP). The majority of HyperAP have been reported in recent years. Surprisingly, only a few of these HyperAP genes have been investigated for their candidacy as the QTL for hypertension. The frequency of candidate genes within peak regions of the QTL is higher than the rest of the QTL region. We also found that QTL located in both gene-rich regions and gene-rich chromosomes contained the most candidate genes. However, the number of candidate genes within a peak region is not associated with the number of total genes in a QTL region. This data could not only facilitate a more rapid and comprehensive identification for the causal genes underlying hypertension in rats, but also provides new insights into genomic structure in regulation of hypertension.

Implication of epigenetic factors in the pathogenesis of type 1 diabetes

Type 1 diabetes(T1D)is an autoimmune disease that resulted from the severe destruction of the insulin-producingβcells in the pancreases of individuals with a genetic predisposition.Genome-wide studies have identified HLA and other risk genes associated with T1D susceptibility in humans.However,evidence obtained from the incomplete concordance of diabetes incidence among monozygotic twins suggests that environmental factors also play critical roles in T1D pathogenesis.Epigenetics is a rapidly growing field that serves as a bridge to link T1D risk genes and environmental exposures,thereby modulating the expression of critical genes relevant to T1D development beyond the changes of DNA sequences.Indeed,there is compelling evidence that epigenetic changes induced by environmental insults are implicated in T1D pathogenesis.Herein,we sought to summarize the recent progress in terms of epigenetic mechanisms in T1D initiation and progression,and discuss their potential as biomarkers and therapeutic targets in the T1D setting.