AIM:To report the clinical prognosis and pathological findings of accidental lens vacuolar changes in eyes with intraoperative exposure to a dispersive ophthalmic viscosurgical device(OVD).METHODS:Two patients who dev...AIM:To report the clinical prognosis and pathological findings of accidental lens vacuolar changes in eyes with intraoperative exposure to a dispersive ophthalmic viscosurgical device(OVD).METHODS:Two patients who developed transient lens vacuolar changes during uneventful persistent pupillary membrane(PPM)removal surgery were presented and followed up.This event was speculated to be associated with an intraoperative dispersive OVD DisCoVisc(hyaluronic acid 1.6%-chondroitin sulfate 4.0%)exposure.Then,to provide the pathological basis for our speculation,another four cataract patients were randomly exposed to different OVDs,and their anterior lens capsules were investigated with transmission electron microscopy(TEM).RESULTS:After months,the subcapsular vacuoles in both PPM cases were gradually disappeared without visual deterioration.For the cataract patients,similar lens changes were observed intraoperatively in those exposed to a dispersive DisCoVisc but not a cohesive OVD IVIZ(sodium hyaluronate gel 1.0%).In addition,marked ultrastructural changes,including chromatin condensation,extensive cytoplasmic vacuoles,and obvious intercellular space between lens epithelial cells in the anterior lens capsules of all eyes exposed to DisCoVisc,were observed by TEM.CONCLUSION:The lens vacuolar changes may be associated with a dispersive OVD exposure.Therefore,it is not preferable to use dispersive OVDs in patients with transparent lenses or without the intention of lens extraction.In addition,close follow-ups instead of immediate lens extraction are recommended for the occurrence of similar lens lesions.展开更多
AIM: To evaluate changes in the anterior chamber depth (ACD), crystalline lens thickness (LT) and its refractive power after laser in situ keratomileusis (LASIK). METHODS: In all cases, the preoperative and postoperat...AIM: To evaluate changes in the anterior chamber depth (ACD), crystalline lens thickness (LT) and its refractive power after laser in situ keratomileusis (LASIK). METHODS: In all cases, the preoperative and postoperative central ACD which were measured with Pentacam, Orbscan, IOL-Master and A-scan ultrasonography, central corneal true net power which was measured with the Pentacam, Orbscan and IOL-Master, axial length (AL) which was measured with IOL-Master and LT which was measured with the A-scan ultrasonography were compared using the paired sample t test. Ocular refractive errors and lens refractive power at corneal plane were calculated and their correlations were also evaluated before and after LASIK. RESULTS: At 1 week after LASIK, LT and crystalline lens refractive power at corneal plane (Dlens) which were associated with the IOL-Master and Pentacam increased significantly (P <= 0.005), ACD decreased significantly (P <= 0.001), but no significant increase was observed in the Diens which was associated with the Orbscan(P=0.261). Significant correlations between the changes in the ocular refractive errors and Diens which were associated with the Pentacam were observed at 1 week and 6 months after LASIK (P = 0.028; P=0.001). CONCLUSION: LT increased significantly after LASIK, and this might partially lead to ACD decrease, Diens increase and a small quantity of myopic regression.展开更多
BACKGROUND Intravitreal injection has become an efficient approach for delivering drugs at therapeutic levels to the posterior segment in retinal diseases.However,the increased frequency and number of intravitreal inj...BACKGROUND Intravitreal injection has become an efficient approach for delivering drugs at therapeutic levels to the posterior segment in retinal diseases.However,the increased frequency and number of intravitreal injections have raised concerns about their side effects.As manipulation during surgery is relatively simple,details of the procedure are easily overlooked.Iatrogenic crystalline lens injury is a rare complication caused by improper manipulation during surgical procedures.We report two cases of crystalline lens injury during intravitreal injection of triamcinolone acetonide(TA)with the hope of providing an insight into this treatment.CASE SUMMARY Case 1 was a 62-year-old woman with macular edema caused by central retinal vein occlusion in her right eye,and Case 2 was a 65-year-old man with macular edema caused by branch retinal vein occlusion in his right eye.In view of the patients’condition and economic constraints,an intravitreal injection of TA was administered.Due to inappropriate manipulation during surgery,the lens was injured.The site of lens injury and clinical manifestations were different in the two cases.Symptomatic treatment and continuous follow-up were carried out.The therapeutic effect following phacoemulsification of the cataract was satisfactory.CONCLUSION Well-defined surgical incision under proper anesthesia,sufficient patient information and proficient anatomical skills of the physician are mandatory to prevent this rare adverse event.Careful and meticulous phacoemulsification of the cataract is suggested.展开更多
AIM: To quantify the changes in the lens profile with accommodation in different age groups. METHODS: The Pentacam HR system was used to obtain the images of the anterior eye segment from 23 young and 15 presbyopic em...AIM: To quantify the changes in the lens profile with accommodation in different age groups. METHODS: The Pentacam HR system was used to obtain the images of the anterior eye segment from 23 young and 15 presbyopic emmetropic subjects in unaccommodated (with an accommodation stimulus of 0.0D) and accommodated (with an accommodation stimulus of 5.0D for the young group and 1.0D for the presbyopic group) states. The phakic crystalline lens shape, including curvature of crystalline lens and central lens thickness (CLT), and the measurements of anterior segment length (ASL), central anterior chamber depth (CACD) were investigated. The anterior chamber volume (ACV) was also measured. RESULTS: The reduction of CACD and ACV were significant in both groups after accommodation stimulus. From the profile of anterior eye segment, a significant decrease in anterior crystalline lens radii of curvature (-2.52mm) and a mean increase in CLT (0.222mm) and ASL (0.1138mm) were found in the. young group with an accommodation stimulus of 5.0D. However, no statistically significant changes of CLT, ASL, or crystalline lens radii of curvature were found in the presbyopic group. CONCLUSION: Our data showed that the shallowing of anterior chamber during accommodation was caused by the forward bulging of the anterior lens surface, rather than by anterior shifting of lens position in either young or presbyopic subjects.展开更多
Dear Editor,I write to present the results of a study on the correlation between the ultrasound energy consumed during phacoemulsification with various preoperative parameters,including best corrected distance visual ...Dear Editor,I write to present the results of a study on the correlation between the ultrasound energy consumed during phacoemulsification with various preoperative parameters,including best corrected distance visual acuity(BCDVA),the signal to noise ratio(SNR)obtained by partial coherence laser interferometry and primarily,lens spikes measurements derived by A-scan ultrasound biometry.Quantification of crystalline lens hardness before cataract removal has been attempted by several researchers in the past.These have been in humans and in animals,in vivo and in vitro,and have used a variety of imaging modalities.展开更多
Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Metho...Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative, interventional study of 31 consecutive cases of patients who underwent 23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens following complicated cataract surgeries using our bimanual technique was conducted. The main outcomes measured included best-corrected visual acuity (BCVA), preoperative intraocular pressure (IOP), postoperative IOP and postoperative complications. Results: In all 31 cases included in this study, those dense posteriorly dislocated crystalline lenses were successfully removed. The enrolled patients consisted of 17 males and 14 females with a mean age of (75.84 ± 6.17) years (range 59 - 90). The mean follow-up length was (7.61 ± 1.87) months with a range of 6 months to 1 year. The mean preoperative BCVA was 0.22 ± 0.11 logMAR system, and the postoperative BCVA was 0.33 ± 0.07 logMAR system after 6 months of follow-up. The mean operative time was 46.32 ± 4.80 minutes with a range of 38.00 to 57.00 minutes. All of the conjunctival incisions self-closed within the first week with no wound leakage or hemorrhage. The postoperative complications were relatively rare. Conclusions: The removal of dense posteriorly dislocated crystalline lens might be a challenge for micro-incision vitrectomy. Our bimanual technique was proved to be an effective and safe method for those particular dense lenses using 23-gauge alone.展开更多
Crystalline porous ionic salts(CPISs) represent a new type of porous materials constructed by electrostatic interaction, however, synthesis of CPISs bearing pre-designed functionality while exhibiting permanent porosi...Crystalline porous ionic salts(CPISs) represent a new type of porous materials constructed by electrostatic interaction, however, synthesis of CPISs bearing pre-designed functionality while exhibiting permanent porosity is still challenging. Herein we report the facile synthesis of a series of CPISs 1-3 built from photocatalytic-active polyoxometalate(POM) clusters and cationic Zr-based capsules, which showed open porous frameworks with BET surface area up to 33 m^(2)/g and high activity and selectivity for photodriven aerobic oxidation of alcohols to aldehydes. Compared with the pristine POM cluster {W10}, 1 can promote the reaction in much higher efficiency due to the concerted catalysis of preinstalled {W10} and Zr-based capsule together with open channels. This work highlights the advantage of CPISs as porous heterogeneous catalysts in organic transformation, and may shed light on the rational design of more delicate CPISs-derived functional materials.展开更多
Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(IOLMaster 700)to scan 131 e...Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(IOLMaster 700)to scan 131 emmetropic eyes(axial length<24.5 mm),25 mild/moderate myopic eyes(axial length 24.5–26 mm),and 123 high myopic eyes(52,29,and 42 eyes with axial lengths of 26–28,28–30,and>30 mm,respectively)as part of the routine preoperative examination before cataract surgery.SS-OCT involved B-scans along six meridians.The data were analyzed to assess the magnitude and orientation of the lens tilt and their correlation with other optical biometric parameters.Result:The mean tilt was 3.36±0.98°in emmetropic eyes,3.07±1.04°in mild/medium myopic eyes,and 2.35±1.01°in high myopic eyes.Tilt correlated significantly and inversely with axial length(Pearson’s r=−0.427,P<0.001).The crystalline lens tilt predominantly faced the upper outer quadrant relative to the visual axis,symmetrically in both eyes,with mean angles of 24.32°and 147.36°in the right and left eyes,respectively.The variability in the lens tilt direction increased with increasing axial length(χ^(2) test,P<0.001).Conclusion:The magnitude of crystalline lens tilt decreased with increasing axial length.The direction of tilt was predominantly towards the upper outer quadrant in both eyes.The variability in the tilt orientation increased with increasing axial length.Trial registration:NIH(clinicaltrial.gov),NCT03062085.Registered 23 February 2017.展开更多
Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(lOLMaster 700)to scan 131 e...Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(lOLMaster 700)to scan 131 emmetropic eyes(axial length<24.5 mm);25 mild/moderate myopic eyes(axial length 24.5-26 mm),and 123 high myopic eyes(52,29,and 42 eyes with axial lengths of 26-28,28-BO,and>30 mm,respectively)as part of the routine preoperative examination before cataract surgery.SS-OCT involved B-scans along six meridians.The data were analyzed to assess the magnitude and orientation of the lens tilt and their correlation with other optical biometric parameters.Result:The mean tilt was 3.36±0.98。in emmetropic eyes,3.07±1.04° in mild/medium myopic eyes,and 2.35±1.01° in high myopic eyes.Tilt correlated significantly and inversely with axial length(Pearson,sr=-0.427,P<0.001).The crystalline lens tilt predominantly faced the upper outer quadrant relative to the visual axis,symmetrically in both eyes,with mean angles of 24.32°and 147.36°in the right and left eyes,respectively.The variability in the lens tilt direction increased with increasing axial length(x2 test,P<0.001).Conclusion:The magnitude of crystalline lens tilt decreased with increasing axial length.The direction of tilt was predominantly towards the upper outer quadrant in both eyes.The variability in the tilt orientation increased with increasing axial length.Trial registration:NIH(clinicaltrial.gov),NCT03062085.Registered 23 February 2017.展开更多
This study evaluated the safety of a modified method to implant an intraocular lens (IOL) into the capsular bag immediately after capsulorhexis with a whole or partial nucleus to protect the posterior capsule (PC) dur...This study evaluated the safety of a modified method to implant an intraocular lens (IOL) into the capsular bag immediately after capsulorhexis with a whole or partial nucleus to protect the posterior capsule (PC) during phacoemulsification in a series of 12 Morgagnian cataracts. For 3 cases of hypermature cataracts with smaller and rigid nuclei, after a complete capsulorhexis, an IOL was directly inserted into the capsular bag, which protected the PC during the subsequent phacoemulsification process in the iris plate. For the other 9 cases with larger and softer nuclei, after the nucleus was partially emulsified, the IOL was inserted into the bag. Even with an obvious surge for some cases, the surgeries were uneventful in all 12 cases, with no PC rent or vitreous loss. IOL implantation into the capsular bag with a whole or partial nucleus can provide effective protection for the PC for hypermature cataract during phacoemulsification.展开更多
·AIM: To compare posterior capsule opacification(PCO)degree and visual functions after phacoemulsification in eyes implanted with 360-degree square edge hydrophilic acrylic intraocular lens(IOL)(570C C-flex, Rayn...·AIM: To compare posterior capsule opacification(PCO)degree and visual functions after phacoemulsification in eyes implanted with 360-degree square edge hydrophilic acrylic intraocular lens(IOL)(570C C-flex, Rayner) and sharp edge hydrophobic acrylic IOL(Sensar AR40 e,AMO) in diabetic patients.· METHODS: Sixty diabetic patients underwent uneventful phacoemulsification and randomly implanted one of the two IOLs. The PCO value was measured by retroillumination photographs and Evaluation of Posterior Capsule Opacification(EPCO) 2000 image-analysis software at 1, 6, 12, and 24 mo after surgery. Visual acuity, and contrast sensitivity in photopic and mesopic conditions were also examined at each follow up time point. The incidence of eye that required Nd:YAG laser posterior capsulotomy were also compared.·RESULTS: There was not any statistically significant difference in PCO scores between Rayner C-flex 570 C group and Sensar AR40 e group at each follow up time point. Visual acuity, Nd:YAG capsulotomy incidence and contrast sensitivity also had no significant difference during the 24 mo follow-up.·CONCLUSION: For diabetic patients, Rayner 570 C Cflex and Sensar AR40 e IOLs are same effective for prevent PCO. The 360-degree square edge design maybe is a good alternative technique to improve PCO prevention.展开更多
AIM: To evaluate the impact of 4 different intraocular lenses(IOLs) on posterior capsule opacification(PCO) by comparing the neodymium: yttrium-aluminum-garnet(Nd:YAG) laser capsulotomy rates.METHODS: This retrospecti...AIM: To evaluate the impact of 4 different intraocular lenses(IOLs) on posterior capsule opacification(PCO) by comparing the neodymium: yttrium-aluminum-garnet(Nd:YAG) laser capsulotomy rates.METHODS: This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies.· RESULTS: An Nd:YAG laser posterior capsulotomy was performed in 153(3.07%) of the 4970 eyes. The mean follow-up time was 84 mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1-and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared.· CONCLUSION: In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design(1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate.展开更多
Background:In patients with incomplete posterior capsule support,posterior chamber intraocular lenses(PC-IOLs)were implanted with both haptics transs-cleral fixation.This causes more damage to the eye and may result i...Background:In patients with incomplete posterior capsule support,posterior chamber intraocular lenses(PC-IOLs)were implanted with both haptics transs-cleral fixation.This causes more damage to the eye and may result in more com-plications,In patients with small posterior breaks,non-fixation or single haptic fixation may be adequate.Methods:Thiry-two consecutive patients of traumatic cataract with posterior capsule breaks caused by penetrating eye trauma were retospected.Posterior chamber intraocular lenses were implanted in all these patients with three tech-niques,ie,without fixation,with single haptic fixation and with both haptics fixation .The selection of the technique was based on the position and size of the posterior capsule.The follow-up period was 21days to 28months(mean,15.2months).Results:Intra-operative problems included ciliary body bleeding(Two patents,6.25%)and enlargement of posterior capsule breaks(2patients,6.25).Postoperative visual acuity was0.5or better(Corrected)in28case(87.5%)and 0.1-0.4in four patients(12.5%),Postoperative complications included hyphema(6eyes,18.8%),transient intraocular pressure elevation(6eyes,18.8%),transient hypotention(7eyes,21.8%).Postoperative IOL position were good except one case of IOL tilt.No pupillary capture or endophthalmitis was found.Conclusions:Not all PC-IOLs have to be fixed by two haptics.In patients with small posterior capsule breaks,PC-IOLmay not be fixed or fixed by only one haptics.Eye Science1995;11:140-142.展开更多
Purpose: To observe the effect of preservation of anterior capsule on the incidence of complications associated with silicone oil.
Methods: 82 patients(82 eyes) accepted trans pars plana vitrectomy(TPPV) combined with...Purpose: To observe the effect of preservation of anterior capsule on the incidence of complications associated with silicone oil.
Methods: 82 patients(82 eyes) accepted trans pars plana vitrectomy(TPPV) combined with lensectomy of whom , 30 eyes with preservation of anterior capsule(PAC) and 52eyes with no preservation of anterior capsule (NPAC). Analysis of the incidence of complications associated with use of oil.
Results:The incidence rate was 50.0 % in NPAC group, and 23.3 % in PAC group( P < 0. 025 ). There were seconda'y glaucoma (21. 1% ), band keratopathy ( 13.5 % ) and corneal decompensation(9.6 % ) in NPAC group, while there was none of them in PAC group.
Conclusions: Preservation of anterior capsule is an eftective method to reduce the complications associated with silicone oil. Eye Science 2001; 17:39 ~ 41.展开更多
AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma,and discuss the multiple treating methods of operation combined with primary...AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma,and discuss the multiple treating methods of operation combined with primary intraocular lens(IOL)implantation.METHODS:Non-comparativeretrospectiveobservational case series.Participants:30 cases(30 eyes)of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi’an No.4Hospital from 2007 to 2011.According to the different situations of lens subluxation/dislocation,various surgical procedures were performed such as crystalline lens phacoemulsification,crystalline lens phacoemulsification combined anterior vitrectomy,intracapsular cataract extraction combined anterior vitrectomy,lensectomy combined anterior vitrectomy though peripheral transparent cornea incision,pars plana lensectomy combined pars plana vitrectomy,and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy.And whether to implement trabeculectomy depended on the different situations of secondary glaucoma.The posterior chamber intraocular lenses(PC-IOLs)were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present.Main outcome measures:visual acuity,intraocular pressure,the situation of intraocular lens and complications after the operations.RESULTS:The follow-up time was 11-36mo(21.4±7.13).Postoperative visual acuity of all eyes were improved;28 cases maintained IOP below 21 mm Hg;2cases had slightly IOL subluxation,4 cases had slightlytilted lens optical area;1 case had postoperative choroidal detachment;4 cases had postoperative corneal edema more than 1wk,but eventually recovered transparent;2 cases had mild postoperative vitreous hemorrhage,and absorbed 4wk later.There was no postoperative retinal detachment,IOL dislocation,and endophthalmitis.CONCLUSION:To take early treatment of traumatic lens subluxation/dislocation in patients with secondary glaucoma by individual surgical plan based on the different eye conditions would be safe and effective,which can effectively control the intraocular pressure and restore some vision.展开更多
The crystalline lens is a transparent,biconvex structure in the eye that,along with the cornea,helps to refract light to be focused on the retina and,by changing shape,it adjusts focal distance(accommodation).The th...The crystalline lens is a transparent,biconvex structure in the eye that,along with the cornea,helps to refract light to be focused on the retina and,by changing shape,it adjusts focal distance(accommodation).The three classes of structural proteins found in the lens areα,β,and γ crystallins.These proteins make up more than 90% of the total dry mass of the eye lens.Other components which can be found are sugars,lipids,water,several antioxidants and low weight molecules.When ageing changes occur in the lens,it causes a gradual reduction in transparency,presbyopia and an increase in the scattering and aberration of light waves as well as a degradation of the optical quality of the eye.The main changes that occur with aging are: 1) reduced diffusion of water from the outside to the inside of the lens and from its cortical to its nuclear zone; 2)crystalline change due to the accumulation of high molecular weight aggregates and insoluble proteins; 3)production of advanced glycation end products(AGEs),lipid accumulation,reduction of reduced glutathione content and destruction of ascorbic acid.Even if effective strategies in preventing cataract onset are not already known,good results have been reached in some cases with oral administration of antioxidant substances such as caffeine,pyruvic acid,epigallocatechin gallate(EGCG),α-lipoic acid and ascorbic acid.Furthermore,methionine sulfoxide reductase A(MSRA) over expression could protect lens cells both in presence and in absence of oxidative stress-induced damage.Nevertheless,promising results have been obtained by reducing ultraviolet-induced oxidative damage.展开更多
Many organisms have evolved an approximately 24-hour circadian rhythm that allows them to achieve internal physiological homeostasis with external environment.Suprachiasmatic nucleus(SCN) is the central pacemaker of...Many organisms have evolved an approximately 24-hour circadian rhythm that allows them to achieve internal physiological homeostasis with external environment.Suprachiasmatic nucleus(SCN) is the central pacemaker of circadian rhythm,and its activity is entrained to the external light-dark cycle.The SCN controls circadian rhythm through regulating the synthesis of melatonin by pineal gland via a multisynaptic pathway.Light,especially shortwavelength blue light,is the most potent environmental time cue in circadian photoentrainment.Recently,the discovery of a novel type of retinal photoreceptors,intrinsically photosensitive retinal ganglion cells,sheds light on the mechanism of circadian photoentrainment and raises concerns about the effect of ocular diseases on circadian system.With age,light transmittance is significantly decreased due to the aging of crystalline lens,thus possibly resulting in progressive loss of circadian photoreception.In the current review,we summarize the circadian physiology,highlight the important role of light in circadian rhythm regulation,discuss about the correlation between age-related cataract and sleep disorders,and compare the effect of blue light-filtering intraocular lenses(lOLs) and ultraviolet only filtering lOLs on circadian rhythm.展开更多
Lens-induced factors are important and common mechanisms causing acute elevation of intraocular pressure. While in most cases, the diagnosis and management are straight-forward, in others it is difficult and can lead ...Lens-induced factors are important and common mechanisms causing acute elevation of intraocular pressure. While in most cases, the diagnosis and management are straight-forward, in others it is difficult and can lead to improper procedures, complications and poor visual outcomes. This review was done with the aim of studying the various types of lens-induced glaucomas, classifying them in an easy way to understand manner, their clinical features, current management and future possibilities.展开更多
基金Supported by the National Key R&D Program of China(No.2020YFC2008200)the National Natural Science Foundation of China(No.81970778,No.82271066,No.81970813)+1 种基金the Natural Science Foundation of Guangdong Province(No.2023A1515011198)Guangzhou Municipal Science and Technology Project(No.SL2022A03J00553).
文摘AIM:To report the clinical prognosis and pathological findings of accidental lens vacuolar changes in eyes with intraoperative exposure to a dispersive ophthalmic viscosurgical device(OVD).METHODS:Two patients who developed transient lens vacuolar changes during uneventful persistent pupillary membrane(PPM)removal surgery were presented and followed up.This event was speculated to be associated with an intraoperative dispersive OVD DisCoVisc(hyaluronic acid 1.6%-chondroitin sulfate 4.0%)exposure.Then,to provide the pathological basis for our speculation,another four cataract patients were randomly exposed to different OVDs,and their anterior lens capsules were investigated with transmission electron microscopy(TEM).RESULTS:After months,the subcapsular vacuoles in both PPM cases were gradually disappeared without visual deterioration.For the cataract patients,similar lens changes were observed intraoperatively in those exposed to a dispersive DisCoVisc but not a cohesive OVD IVIZ(sodium hyaluronate gel 1.0%).In addition,marked ultrastructural changes,including chromatin condensation,extensive cytoplasmic vacuoles,and obvious intercellular space between lens epithelial cells in the anterior lens capsules of all eyes exposed to DisCoVisc,were observed by TEM.CONCLUSION:The lens vacuolar changes may be associated with a dispersive OVD exposure.Therefore,it is not preferable to use dispersive OVDs in patients with transparent lenses or without the intention of lens extraction.In addition,close follow-ups instead of immediate lens extraction are recommended for the occurrence of similar lens lesions.
文摘AIM: To evaluate changes in the anterior chamber depth (ACD), crystalline lens thickness (LT) and its refractive power after laser in situ keratomileusis (LASIK). METHODS: In all cases, the preoperative and postoperative central ACD which were measured with Pentacam, Orbscan, IOL-Master and A-scan ultrasonography, central corneal true net power which was measured with the Pentacam, Orbscan and IOL-Master, axial length (AL) which was measured with IOL-Master and LT which was measured with the A-scan ultrasonography were compared using the paired sample t test. Ocular refractive errors and lens refractive power at corneal plane were calculated and their correlations were also evaluated before and after LASIK. RESULTS: At 1 week after LASIK, LT and crystalline lens refractive power at corneal plane (Dlens) which were associated with the IOL-Master and Pentacam increased significantly (P <= 0.005), ACD decreased significantly (P <= 0.001), but no significant increase was observed in the Diens which was associated with the Orbscan(P=0.261). Significant correlations between the changes in the ocular refractive errors and Diens which were associated with the Pentacam were observed at 1 week and 6 months after LASIK (P = 0.028; P=0.001). CONCLUSION: LT increased significantly after LASIK, and this might partially lead to ACD decrease, Diens increase and a small quantity of myopic regression.
基金Supported by Scientific Research Projects of Shanghai Municipal Health and Family Planning Commission,No.201640049
文摘BACKGROUND Intravitreal injection has become an efficient approach for delivering drugs at therapeutic levels to the posterior segment in retinal diseases.However,the increased frequency and number of intravitreal injections have raised concerns about their side effects.As manipulation during surgery is relatively simple,details of the procedure are easily overlooked.Iatrogenic crystalline lens injury is a rare complication caused by improper manipulation during surgical procedures.We report two cases of crystalline lens injury during intravitreal injection of triamcinolone acetonide(TA)with the hope of providing an insight into this treatment.CASE SUMMARY Case 1 was a 62-year-old woman with macular edema caused by central retinal vein occlusion in her right eye,and Case 2 was a 65-year-old man with macular edema caused by branch retinal vein occlusion in his right eye.In view of the patients’condition and economic constraints,an intravitreal injection of TA was administered.Due to inappropriate manipulation during surgery,the lens was injured.The site of lens injury and clinical manifestations were different in the two cases.Symptomatic treatment and continuous follow-up were carried out.The therapeutic effect following phacoemulsification of the cataract was satisfactory.CONCLUSION Well-defined surgical incision under proper anesthesia,sufficient patient information and proficient anatomical skills of the physician are mandatory to prevent this rare adverse event.Careful and meticulous phacoemulsification of the cataract is suggested.
基金Supported by National Natural Science Foundation of China (No. 81070747)Research Award for New Century Excellent Talents in University (No. NCET08-0586)in ChinaScience and Technology Planning Project of Guangdong Province, China (No.2010B090400416)
文摘AIM: To quantify the changes in the lens profile with accommodation in different age groups. METHODS: The Pentacam HR system was used to obtain the images of the anterior eye segment from 23 young and 15 presbyopic emmetropic subjects in unaccommodated (with an accommodation stimulus of 0.0D) and accommodated (with an accommodation stimulus of 5.0D for the young group and 1.0D for the presbyopic group) states. The phakic crystalline lens shape, including curvature of crystalline lens and central lens thickness (CLT), and the measurements of anterior segment length (ASL), central anterior chamber depth (CACD) were investigated. The anterior chamber volume (ACV) was also measured. RESULTS: The reduction of CACD and ACV were significant in both groups after accommodation stimulus. From the profile of anterior eye segment, a significant decrease in anterior crystalline lens radii of curvature (-2.52mm) and a mean increase in CLT (0.222mm) and ASL (0.1138mm) were found in the. young group with an accommodation stimulus of 5.0D. However, no statistically significant changes of CLT, ASL, or crystalline lens radii of curvature were found in the presbyopic group. CONCLUSION: Our data showed that the shallowing of anterior chamber during accommodation was caused by the forward bulging of the anterior lens surface, rather than by anterior shifting of lens position in either young or presbyopic subjects.
文摘Dear Editor,I write to present the results of a study on the correlation between the ultrasound energy consumed during phacoemulsification with various preoperative parameters,including best corrected distance visual acuity(BCDVA),the signal to noise ratio(SNR)obtained by partial coherence laser interferometry and primarily,lens spikes measurements derived by A-scan ultrasound biometry.Quantification of crystalline lens hardness before cataract removal has been attempted by several researchers in the past.These have been in humans and in animals,in vivo and in vitro,and have used a variety of imaging modalities.
文摘Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative, interventional study of 31 consecutive cases of patients who underwent 23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens following complicated cataract surgeries using our bimanual technique was conducted. The main outcomes measured included best-corrected visual acuity (BCVA), preoperative intraocular pressure (IOP), postoperative IOP and postoperative complications. Results: In all 31 cases included in this study, those dense posteriorly dislocated crystalline lenses were successfully removed. The enrolled patients consisted of 17 males and 14 females with a mean age of (75.84 ± 6.17) years (range 59 - 90). The mean follow-up length was (7.61 ± 1.87) months with a range of 6 months to 1 year. The mean preoperative BCVA was 0.22 ± 0.11 logMAR system, and the postoperative BCVA was 0.33 ± 0.07 logMAR system after 6 months of follow-up. The mean operative time was 46.32 ± 4.80 minutes with a range of 38.00 to 57.00 minutes. All of the conjunctival incisions self-closed within the first week with no wound leakage or hemorrhage. The postoperative complications were relatively rare. Conclusions: The removal of dense posteriorly dislocated crystalline lens might be a challenge for micro-incision vitrectomy. Our bimanual technique was proved to be an effective and safe method for those particular dense lenses using 23-gauge alone.
基金supported by National Natural Science Foundation of China (Nos. 92161111, 21901037, 21901038)Shanghai Pujiang Program (No. 19PJ1400200)+1 种基金the Program for Professor of Special Appointment (Eastern Scholar) at Shanghai Institutions of Higher LearningFundamental Research Funds for the Central Universities (No. 2232019G-07)。
文摘Crystalline porous ionic salts(CPISs) represent a new type of porous materials constructed by electrostatic interaction, however, synthesis of CPISs bearing pre-designed functionality while exhibiting permanent porosity is still challenging. Herein we report the facile synthesis of a series of CPISs 1-3 built from photocatalytic-active polyoxometalate(POM) clusters and cationic Zr-based capsules, which showed open porous frameworks with BET surface area up to 33 m^(2)/g and high activity and selectivity for photodriven aerobic oxidation of alcohols to aldehydes. Compared with the pristine POM cluster {W10}, 1 can promote the reaction in much higher efficiency due to the concerted catalysis of preinstalled {W10} and Zr-based capsule together with open channels. This work highlights the advantage of CPISs as porous heterogeneous catalysts in organic transformation, and may shed light on the rational design of more delicate CPISs-derived functional materials.
基金This research was funded by research grants from the National Natural Science Foundation of China(81870642,81970780,81470613,81100653,81670835,and 81270989)the National Key R&D Program of China(2018YFC0116800)+2 种基金the Shanghai Talent Development Fund(201604)the Shanghai Youth Doctor Support Program(2014118)the Outstanding Youth Medical Talents Program of the Shanghai Health and Family Planning Commission(2017YQ011).
文摘Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(IOLMaster 700)to scan 131 emmetropic eyes(axial length<24.5 mm),25 mild/moderate myopic eyes(axial length 24.5–26 mm),and 123 high myopic eyes(52,29,and 42 eyes with axial lengths of 26–28,28–30,and>30 mm,respectively)as part of the routine preoperative examination before cataract surgery.SS-OCT involved B-scans along six meridians.The data were analyzed to assess the magnitude and orientation of the lens tilt and their correlation with other optical biometric parameters.Result:The mean tilt was 3.36±0.98°in emmetropic eyes,3.07±1.04°in mild/medium myopic eyes,and 2.35±1.01°in high myopic eyes.Tilt correlated significantly and inversely with axial length(Pearson’s r=−0.427,P<0.001).The crystalline lens tilt predominantly faced the upper outer quadrant relative to the visual axis,symmetrically in both eyes,with mean angles of 24.32°and 147.36°in the right and left eyes,respectively.The variability in the lens tilt direction increased with increasing axial length(χ^(2) test,P<0.001).Conclusion:The magnitude of crystalline lens tilt decreased with increasing axial length.The direction of tilt was predominantly towards the upper outer quadrant in both eyes.The variability in the tilt orientation increased with increasing axial length.Trial registration:NIH(clinicaltrial.gov),NCT03062085.Registered 23 February 2017.
基金This research was funded by research grants from the National Natural Science Foundation of China(81870642,81970780,81470613,81100653,81670835,and 81270989)the National Key R&D Program of China(2018YFC0116800)+2 种基金the Shanghai Talent Development Fund(201604)the Shanghai Youth Doaor Support Program(2014118)and the Outstanding Youth Medical Talents Program of the Shanghai Health and Family Planning Commission(2017YQ011).
文摘Background:To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography(SS-OCT).Methods:We used SS-OCT(lOLMaster 700)to scan 131 emmetropic eyes(axial length<24.5 mm);25 mild/moderate myopic eyes(axial length 24.5-26 mm),and 123 high myopic eyes(52,29,and 42 eyes with axial lengths of 26-28,28-BO,and>30 mm,respectively)as part of the routine preoperative examination before cataract surgery.SS-OCT involved B-scans along six meridians.The data were analyzed to assess the magnitude and orientation of the lens tilt and their correlation with other optical biometric parameters.Result:The mean tilt was 3.36±0.98。in emmetropic eyes,3.07±1.04° in mild/medium myopic eyes,and 2.35±1.01° in high myopic eyes.Tilt correlated significantly and inversely with axial length(Pearson,sr=-0.427,P<0.001).The crystalline lens tilt predominantly faced the upper outer quadrant relative to the visual axis,symmetrically in both eyes,with mean angles of 24.32°and 147.36°in the right and left eyes,respectively.The variability in the lens tilt direction increased with increasing axial length(x2 test,P<0.001).Conclusion:The magnitude of crystalline lens tilt decreased with increasing axial length.The direction of tilt was predominantly towards the upper outer quadrant in both eyes.The variability in the tilt orientation increased with increasing axial length.Trial registration:NIH(clinicaltrial.gov),NCT03062085.Registered 23 February 2017.
基金Supported by National Natural Science Foundation of China(No.81570830,No.81670817)Key R&D Program Projects in Shaanxi Province(No.2017SF-273)+2 种基金the Tianjin Research Program of Application Foundation and Advanced Technology(No.17JCYBJC27200)the Science&Technology Foundation for Selected Overseas Chinese Scholar,Bureau of Personnel of China,Tianjin,and Talent Innovation Group of 131,Bureau of Personnel,Tianjin,Tianjin Science and Technology Project(Popularization of Science 17KPHDSF00230)Xi’an Science and Technology Project [No.2017116SF/YX010(1)
文摘This study evaluated the safety of a modified method to implant an intraocular lens (IOL) into the capsular bag immediately after capsulorhexis with a whole or partial nucleus to protect the posterior capsule (PC) during phacoemulsification in a series of 12 Morgagnian cataracts. For 3 cases of hypermature cataracts with smaller and rigid nuclei, after a complete capsulorhexis, an IOL was directly inserted into the capsular bag, which protected the PC during the subsequent phacoemulsification process in the iris plate. For the other 9 cases with larger and softer nuclei, after the nucleus was partially emulsified, the IOL was inserted into the bag. Even with an obvious surge for some cases, the surgeries were uneventful in all 12 cases, with no PC rent or vitreous loss. IOL implantation into the capsular bag with a whole or partial nucleus can provide effective protection for the PC for hypermature cataract during phacoemulsification.
基金Supported by the National Natural Science Foundation of China(No.30901644)the Fundamental Research Funds for the Central Universities of China
文摘·AIM: To compare posterior capsule opacification(PCO)degree and visual functions after phacoemulsification in eyes implanted with 360-degree square edge hydrophilic acrylic intraocular lens(IOL)(570C C-flex, Rayner) and sharp edge hydrophobic acrylic IOL(Sensar AR40 e,AMO) in diabetic patients.· METHODS: Sixty diabetic patients underwent uneventful phacoemulsification and randomly implanted one of the two IOLs. The PCO value was measured by retroillumination photographs and Evaluation of Posterior Capsule Opacification(EPCO) 2000 image-analysis software at 1, 6, 12, and 24 mo after surgery. Visual acuity, and contrast sensitivity in photopic and mesopic conditions were also examined at each follow up time point. The incidence of eye that required Nd:YAG laser posterior capsulotomy were also compared.·RESULTS: There was not any statistically significant difference in PCO scores between Rayner C-flex 570 C group and Sensar AR40 e group at each follow up time point. Visual acuity, Nd:YAG capsulotomy incidence and contrast sensitivity also had no significant difference during the 24 mo follow-up.·CONCLUSION: For diabetic patients, Rayner 570 C Cflex and Sensar AR40 e IOLs are same effective for prevent PCO. The 360-degree square edge design maybe is a good alternative technique to improve PCO prevention.
文摘AIM: To evaluate the impact of 4 different intraocular lenses(IOLs) on posterior capsule opacification(PCO) by comparing the neodymium: yttrium-aluminum-garnet(Nd:YAG) laser capsulotomy rates.METHODS: This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies.· RESULTS: An Nd:YAG laser posterior capsulotomy was performed in 153(3.07%) of the 4970 eyes. The mean follow-up time was 84 mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1-and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared.· CONCLUSION: In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design(1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate.
文摘Background:In patients with incomplete posterior capsule support,posterior chamber intraocular lenses(PC-IOLs)were implanted with both haptics transs-cleral fixation.This causes more damage to the eye and may result in more com-plications,In patients with small posterior breaks,non-fixation or single haptic fixation may be adequate.Methods:Thiry-two consecutive patients of traumatic cataract with posterior capsule breaks caused by penetrating eye trauma were retospected.Posterior chamber intraocular lenses were implanted in all these patients with three tech-niques,ie,without fixation,with single haptic fixation and with both haptics fixation .The selection of the technique was based on the position and size of the posterior capsule.The follow-up period was 21days to 28months(mean,15.2months).Results:Intra-operative problems included ciliary body bleeding(Two patents,6.25%)and enlargement of posterior capsule breaks(2patients,6.25).Postoperative visual acuity was0.5or better(Corrected)in28case(87.5%)and 0.1-0.4in four patients(12.5%),Postoperative complications included hyphema(6eyes,18.8%),transient intraocular pressure elevation(6eyes,18.8%),transient hypotention(7eyes,21.8%).Postoperative IOL position were good except one case of IOL tilt.No pupillary capture or endophthalmitis was found.Conclusions:Not all PC-IOLs have to be fixed by two haptics.In patients with small posterior capsule breaks,PC-IOLmay not be fixed or fixed by only one haptics.Eye Science1995;11:140-142.
文摘Purpose: To observe the effect of preservation of anterior capsule on the incidence of complications associated with silicone oil.
Methods: 82 patients(82 eyes) accepted trans pars plana vitrectomy(TPPV) combined with lensectomy of whom , 30 eyes with preservation of anterior capsule(PAC) and 52eyes with no preservation of anterior capsule (NPAC). Analysis of the incidence of complications associated with use of oil.
Results:The incidence rate was 50.0 % in NPAC group, and 23.3 % in PAC group( P < 0. 025 ). There were seconda'y glaucoma (21. 1% ), band keratopathy ( 13.5 % ) and corneal decompensation(9.6 % ) in NPAC group, while there was none of them in PAC group.
Conclusions: Preservation of anterior capsule is an eftective method to reduce the complications associated with silicone oil. Eye Science 2001; 17:39 ~ 41.
文摘AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma,and discuss the multiple treating methods of operation combined with primary intraocular lens(IOL)implantation.METHODS:Non-comparativeretrospectiveobservational case series.Participants:30 cases(30 eyes)of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi’an No.4Hospital from 2007 to 2011.According to the different situations of lens subluxation/dislocation,various surgical procedures were performed such as crystalline lens phacoemulsification,crystalline lens phacoemulsification combined anterior vitrectomy,intracapsular cataract extraction combined anterior vitrectomy,lensectomy combined anterior vitrectomy though peripheral transparent cornea incision,pars plana lensectomy combined pars plana vitrectomy,and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy.And whether to implement trabeculectomy depended on the different situations of secondary glaucoma.The posterior chamber intraocular lenses(PC-IOLs)were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present.Main outcome measures:visual acuity,intraocular pressure,the situation of intraocular lens and complications after the operations.RESULTS:The follow-up time was 11-36mo(21.4±7.13).Postoperative visual acuity of all eyes were improved;28 cases maintained IOP below 21 mm Hg;2cases had slightly IOL subluxation,4 cases had slightlytilted lens optical area;1 case had postoperative choroidal detachment;4 cases had postoperative corneal edema more than 1wk,but eventually recovered transparent;2 cases had mild postoperative vitreous hemorrhage,and absorbed 4wk later.There was no postoperative retinal detachment,IOL dislocation,and endophthalmitis.CONCLUSION:To take early treatment of traumatic lens subluxation/dislocation in patients with secondary glaucoma by individual surgical plan based on the different eye conditions would be safe and effective,which can effectively control the intraocular pressure and restore some vision.
文摘The crystalline lens is a transparent,biconvex structure in the eye that,along with the cornea,helps to refract light to be focused on the retina and,by changing shape,it adjusts focal distance(accommodation).The three classes of structural proteins found in the lens areα,β,and γ crystallins.These proteins make up more than 90% of the total dry mass of the eye lens.Other components which can be found are sugars,lipids,water,several antioxidants and low weight molecules.When ageing changes occur in the lens,it causes a gradual reduction in transparency,presbyopia and an increase in the scattering and aberration of light waves as well as a degradation of the optical quality of the eye.The main changes that occur with aging are: 1) reduced diffusion of water from the outside to the inside of the lens and from its cortical to its nuclear zone; 2)crystalline change due to the accumulation of high molecular weight aggregates and insoluble proteins; 3)production of advanced glycation end products(AGEs),lipid accumulation,reduction of reduced glutathione content and destruction of ascorbic acid.Even if effective strategies in preventing cataract onset are not already known,good results have been reached in some cases with oral administration of antioxidant substances such as caffeine,pyruvic acid,epigallocatechin gallate(EGCG),α-lipoic acid and ascorbic acid.Furthermore,methionine sulfoxide reductase A(MSRA) over expression could protect lens cells both in presence and in absence of oxidative stress-induced damage.Nevertheless,promising results have been obtained by reducing ultraviolet-induced oxidative damage.
文摘Many organisms have evolved an approximately 24-hour circadian rhythm that allows them to achieve internal physiological homeostasis with external environment.Suprachiasmatic nucleus(SCN) is the central pacemaker of circadian rhythm,and its activity is entrained to the external light-dark cycle.The SCN controls circadian rhythm through regulating the synthesis of melatonin by pineal gland via a multisynaptic pathway.Light,especially shortwavelength blue light,is the most potent environmental time cue in circadian photoentrainment.Recently,the discovery of a novel type of retinal photoreceptors,intrinsically photosensitive retinal ganglion cells,sheds light on the mechanism of circadian photoentrainment and raises concerns about the effect of ocular diseases on circadian system.With age,light transmittance is significantly decreased due to the aging of crystalline lens,thus possibly resulting in progressive loss of circadian photoreception.In the current review,we summarize the circadian physiology,highlight the important role of light in circadian rhythm regulation,discuss about the correlation between age-related cataract and sleep disorders,and compare the effect of blue light-filtering intraocular lenses(lOLs) and ultraviolet only filtering lOLs on circadian rhythm.
文摘Lens-induced factors are important and common mechanisms causing acute elevation of intraocular pressure. While in most cases, the diagnosis and management are straight-forward, in others it is difficult and can lead to improper procedures, complications and poor visual outcomes. This review was done with the aim of studying the various types of lens-induced glaucomas, classifying them in an easy way to understand manner, their clinical features, current management and future possibilities.