AIM:To identify the genetic defect in a Chinese family with bilateral progressive childhood posterior cataract. METHODS:A two-generation family was recruited in this study. Family history and clinical data were record...AIM:To identify the genetic defect in a Chinese family with bilateral progressive childhood posterior cataract. METHODS:A two-generation family was recruited in this study. Family history and clinical data were recorded. All reported candidate genes associated with congenital posterior cataract were screened by direct DNA sequencing. ·RESULTS:All affected individuals presented posterior opacities in the lens. Direct sequencing of the candidate genes showed a heterozygous c. 2668C 】T variation in EPHA2 gene, which resulted in the replacement of arginine by cysteine at codon 890 (p. R890C). This mutation was found in two affected individuals, but was not observed in 200 normal controls. ·CONCLUSION:We report a novel mutation (p. R890C) in the EPHA2 receptor tyrosine kinase gene. The finding expands the mutation spectrum of EPHA2 in association with posterior cataract.展开更多
Background: Cataract surgery is the most frequently performed surgery worldwide. Posterior capsule rupture (PCR) remains one of the most common complications of cataract surgery and a major risk factor for poor visual...Background: Cataract surgery is the most frequently performed surgery worldwide. Posterior capsule rupture (PCR) remains one of the most common complications of cataract surgery and a major risk factor for poor visual outcomes. Cataract surgeries complicated by PCR and vitreous loss are managed with anterior vitrectomy at the time of surgery. However, the situation can be further complicated by dropping lens particles into the vitreous cavity necessitating a secondary pars plana vitrectomy (PPV). Purpose: To compare the visual outcomes and risk of rhegmatogenous retinal detachment (RRD) between eyes that required anterior vitrectomy (AV) alone for the management of vitreous loss and eyes that required AV and subsequent PPV for the management of dropped nuclear lens fragments (DNLF) following cataract surgery complicated by PCR in a tertiary care teaching hospital in Saudi Arabia. Methods: Medical records of patients in whom PCR occurred during phacoemulsification cataract surgery requiring AV or subsequent PPV for DNLF were retrospectively reviewed over a 6-year period from January 2016 to December 2021. Results: PCR occurred in 183 (2.3%) of 7757 consecutive eyes that underwent phacoemulsification cataract surgery during the study period. Seven eyes were excluded from analysis for missing data or short follow-up. Of the 176 eyes, 147 eyes (83.5%) were managed with AV alone, and the remaining 29 eyes (16.5%) underwent a secondary PPV for DNLF. After excluding eyes with pre-existing ocular pathology, final best-corrected visual acuity (BCVA) was similar in both groups with a mean of 0.32 logMAR (P = 0.99). Two of 147 eyes (1.4%) in the AV group developed RRD with poor final BCVA whereas none of the eyes in DNLF group developed RRD. Conclusion: The risk of RRD is lower in eyes that required PPV for DNLF than in eyes that were managed with AV alone following PCR during cataract surgery. The poor visual outcomes in eyes that suffered RRD underscore the importance of postoperative retinal examination and early detection of retinal breaks.展开更多
AIM:To compare the visual outcomes of children with small(≤3 mm)posterior polar cataracts(PPC)and posterior lenticonus who had cataract extraction surgery with the visual outcomes of those who were managed conservati...AIM:To compare the visual outcomes of children with small(≤3 mm)posterior polar cataracts(PPC)and posterior lenticonus who had cataract extraction surgery with the visual outcomes of those who were managed conservatively.METHODS:Children who initially had small PPC and posterior lenticonus who were followed up over 1-year period were retrospective reviewed in the study.Patients receiving surgery were compared with those receiving conservative therapy.The axial length,keratometry,refraction,bestcorrected visual acuity(BCVA),and strabismus measurements were recorded.Lens morphology,i.e.,the location,size,and depth of the cataract lesion,was measured with a Scheimpflug imaging system.To help control for baseline differences in the groups,patients were matched with controls by propensity score methodology.RESULTS:The study evaluated 60 patients(30 in the surgery group and 30 in the conservative therapy group)after matching by propensity score.Patients who underwent cataract surgery showed greater BCVA improvements(0.36±0.24 logMAR)than patients who were treated without surgery(0.22±0.26 logMAR;P=0.036).Surgery was effective in patients with a rear projection length(RPL)less than 1.0 mm and a pretreatment BCVA worse than 0.52 logMAR.CONCLUSION:Children with small PPC and posterior lenticonus who undergo cataract surgery experience greater BCVA improvements than those managed conservatively.Certain patients presenting with a RPL less than 1.0 mm and a pretreatment BCVA of 0.52 logMAR or worse may benefit from surgery.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
Although cataract surgery in posterior polar cataract is associated with posterior capsular rent and nucleus drop, by taking precautions the rate of complication can be decreased. The aim of this article is to review ...Although cataract surgery in posterior polar cataract is associated with posterior capsular rent and nucleus drop, by taking precautions the rate of complication can be decreased. The aim of this article is to review the etiology, pathogenesis, clinical features, and management of posterior polar cataract.展开更多
AIM: To explore the effect of the posterior astigmatism on total corneal astigmatism and evaluate the error caused by substituting the corneal astigmatism of the simulated keratometriy (simulated K) for the total c...AIM: To explore the effect of the posterior astigmatism on total corneal astigmatism and evaluate the error caused by substituting the corneal astigmatism of the simulated keratometriy (simulated K) for the total corneal astigmatism in age-related cataract patients. METHODS: A total of 211 eyes with age-related cataract from 164 patients (mean age: 66.8±9.0y, range: 45-83y) were examined using a multi-colored spot reflection topographer, and the total corneal astigmatism was measured. The power vector components J0 and J45 were analyzed. Correlations between the magnitude difference of the simulated K and total cornea astigmatism (magnitude differenceSimK-Tca), anterior J0, and absolute meridian difference (AMD) between the anterior and posterior astigmatisms were calculated. To compare the astigmatism of the simulated K and total cornea both in magnitude and axial orientation, we drew double-angle plots and calculated the vector difference between the two measures using vector analysis. A corrective regression formula was used to adjust the magnitude of the simulated K astigmatism to approach that of the total cornea. RESULTS: The magnitude differenceSimK-Tca was positively correlated with the anterior corneal J0 (Spearman’s rho= 0.539; P〈0.001) and negatively correlated with the AMDR (Spearman’s rho=-0.875, P〈0.001). When the anterior J0 value was larger than 1.3 D or smaller than -0.8 D, the errors caused by determining the total corneal astigmatism with the karatometric calculation tended to be greater than 0.25 D. An underestimation by 16% was observed for against the rule (ATR) astigmatism and an overestimation by 9% was observed for with the rule (WTR) astigmatism when ignoring the posterior measurements. CONCLUSION: Posterior corneal astigmatism should be valued for more precise corneal astigmatism management, especially for higher ATR astigmatism of the anterior corneal surface. We suggest a 9% reduction in the magnitude of the simulated K in eyes with WTR astigmatism, and a 16% addition of the magnitude of the simulated K in eyes with ATR astigmatism.展开更多
Twenty-five cases of posterior chamber IOL implantation intraumatic cataract with complications associated with primary injury werereported.The operating methods were described and the post-operative com-plications we...Twenty-five cases of posterior chamber IOL implantation intraumatic cataract with complications associated with primary injury werereported.The operating methods were described and the post-operative com-plications were discussed.Seventy-two percent of patients have the correctvision over 20/40.It is suggested that the posterior chamber IOL can be im-planted in traumatic cataract with some injured complications.EYE SCIENCE1992;8:111-112.展开更多
Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this comb...Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.展开更多
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: Elect...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.展开更多
AIMTo compare the effectiveness and safety of pars plana capsulotomy and vitrectomy using 25-gauge tansconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system for posterior capsule opacification (PCO)...AIMTo compare the effectiveness and safety of pars plana capsulotomy and vitrectomy using 25-gauge tansconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system for posterior capsule opacification (PCO) in pseudophakic children.METHODSRetrospectively study. Pars plana capsulotomy and vitrectomy using 25-gauge sutureless vitrectomy system was performed for PCO in the study group (32 eyes). Patients in the control group (34 eyes) underwent capsulotomy and vitrectomy using standard 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), and intraoperative and postoperative complications. The two groups were performed consequentially. The patients ages ranged from 2 to 13y (means: 6.61±2.73y). Surgical technique, intraoperative and postoperative complications, visual acuity, IOP, and recurrent PCO were recorded.RESULTSThe surgical procedure was performed uneventfully in all patients. Visual acuity improved significantly in both groups. BCVA improved in 22 eyes (81.5%) in the study group and in 28 eyes (87.5%) in the control group. There was no statistical difference of visual acuity that were attainable in two groups (H=0.115, P=0.909). Mean postoperative IOP showed no significant difference between the groups at 1wk. All sort of PCO were accomplished by 20-gauge system, while 25-gauge system was effective for pearls style and 2 grade of fibrous PCO, and was insufficient to grade 3 of PCO. In the study group two cases were not accomplished by 25-gauge system while 20-gauge system conquered them. Compared with the control group, mean operative time for opening and closing the sclerotomy in the study group was considerably reduced. The mean follow-up was 38.2mo (range: 8-79mo). During the follow-up period, no incision leakage, corneal edema, vitreous loss, IOL damage, retinal detachment, recurrent PCO, or other complications were noted.CONCLUSIONPars plana capsulotomy and vitrectomy using 25-gauge transconjunctival sutureless vitrectomy appeared to be a safe and effective approach for PCO in pseudophakic children. Combined sutureless surgery needed shorter setup time for sclerotomy and caused less surgical trauma than combined surgery with 20-gauge vitrectomy. Therefore, this type of procedure would be a good option for selected cases with PCO in pseudophakic children.展开更多
AIM:To investigate the effects of a new opening pattern in neodymium:yttrium-aluminum-garnet(Nd:YAG)laser posterior capsulotomy on visual function.METHODS:This technique was conducted along a circular pattern.The ener...AIM:To investigate the effects of a new opening pattern in neodymium:yttrium-aluminum-garnet(Nd:YAG)laser posterior capsulotomy on visual function.METHODS:This technique was conducted along a circular pattern.The energy ranged between 0.8 and1.2 mJ/pulse was consumed and mean total energy levels were 74±21 mJ(mean±standard deviation:SD,from 40 to167)and laser shots aimed at 150μm away behind a datum point and went along an imaginary line which extends 0.5 mm inside from optic margin and into the circular en bloc pattern.Vitreous stands were attached with fragment and then they were cut off by the laser after circular application.The circular fragment was completely separated from vitreous,and then this fragment was quickly sunk in intravitreal space.RESULTS:The follow-up period ranges from at least a week to 40mo,making 15.8mo on average.The procedural outcome showed 96%(74 eyes out of the 77eyes)enhancement in patients’visual acuity.Cystoid macular edema or retinal detachment was not observed in any of the patients during follow-up periods.CONCLUSION:This new technique is expected to improve the weaknesses that the conventional procedures have by adding the process to cut off vitreous stands attached with the fragment by the laser to the circular application.展开更多
BACKGROUND Hypoparathyroidism is uncommon,and cataracts secondary to hypoparathyroidism are even rarer.Herein,we report a case of bilateral cataracts following hypoparathyroidism.CASE SUMMARY A 27-year-old man present...BACKGROUND Hypoparathyroidism is uncommon,and cataracts secondary to hypoparathyroidism are even rarer.Herein,we report a case of bilateral cataracts following hypoparathyroidism.CASE SUMMARY A 27-year-old man presented to our hospital because of painless and progressive visual impairment of both eyes over two years.He was previously diagnosed with hypocalcemia but did not take calcium supplements regularly.He had no history of anterior neck thyroid surgery.After admission,the biochemical analysis indicated a serum calcium level of 1.21 mmol/L and an intact parathyroid hormone level of 0 pg/mL.Ocular examination revealed bilateral symmetrical opacity of the lens presenting as punctate opacity in the posterior subcapsular cortex together with radial opacity in the peripheral cortex(N1C2P3).Phacoemulsification with an intraocular lens was performed in both eyes sequentially.Postoperatively,the patient had a satisfactory recovery and greatly improved visual acuity.CONCLUSION This patient had hypocalcemia owing to idiopathic parathyroid insufficiency.Hypoparathyroidism may go unnoticed for years but with some latent clinical manifestations,such as bilateral symmetrical posterior subcapsular cataracts.This case report highlights that the cause of hypocalcemia in particularly young patients should be further investigated.Clinicians should be aware of hypoparathyroidism as a cause of bilateral cataracts.Early identification of hypoparathyroidism can save patients from further complications.展开更多
基金Science and Technology Program of Zhejiang University, China (No. 2011FZA70130)Medical Science and Technology Project of Zhejiang Province, China(No. 2010QNA012)+1 种基金Zhejiang Key Innovation Team Project of China (No. 2009R50039)Zhejiang Key Laboratory Found of China (No. 2011E10006)
文摘AIM:To identify the genetic defect in a Chinese family with bilateral progressive childhood posterior cataract. METHODS:A two-generation family was recruited in this study. Family history and clinical data were recorded. All reported candidate genes associated with congenital posterior cataract were screened by direct DNA sequencing. ·RESULTS:All affected individuals presented posterior opacities in the lens. Direct sequencing of the candidate genes showed a heterozygous c. 2668C 】T variation in EPHA2 gene, which resulted in the replacement of arginine by cysteine at codon 890 (p. R890C). This mutation was found in two affected individuals, but was not observed in 200 normal controls. ·CONCLUSION:We report a novel mutation (p. R890C) in the EPHA2 receptor tyrosine kinase gene. The finding expands the mutation spectrum of EPHA2 in association with posterior cataract.
文摘Background: Cataract surgery is the most frequently performed surgery worldwide. Posterior capsule rupture (PCR) remains one of the most common complications of cataract surgery and a major risk factor for poor visual outcomes. Cataract surgeries complicated by PCR and vitreous loss are managed with anterior vitrectomy at the time of surgery. However, the situation can be further complicated by dropping lens particles into the vitreous cavity necessitating a secondary pars plana vitrectomy (PPV). Purpose: To compare the visual outcomes and risk of rhegmatogenous retinal detachment (RRD) between eyes that required anterior vitrectomy (AV) alone for the management of vitreous loss and eyes that required AV and subsequent PPV for the management of dropped nuclear lens fragments (DNLF) following cataract surgery complicated by PCR in a tertiary care teaching hospital in Saudi Arabia. Methods: Medical records of patients in whom PCR occurred during phacoemulsification cataract surgery requiring AV or subsequent PPV for DNLF were retrospectively reviewed over a 6-year period from January 2016 to December 2021. Results: PCR occurred in 183 (2.3%) of 7757 consecutive eyes that underwent phacoemulsification cataract surgery during the study period. Seven eyes were excluded from analysis for missing data or short follow-up. Of the 176 eyes, 147 eyes (83.5%) were managed with AV alone, and the remaining 29 eyes (16.5%) underwent a secondary PPV for DNLF. After excluding eyes with pre-existing ocular pathology, final best-corrected visual acuity (BCVA) was similar in both groups with a mean of 0.32 logMAR (P = 0.99). Two of 147 eyes (1.4%) in the AV group developed RRD with poor final BCVA whereas none of the eyes in DNLF group developed RRD. Conclusion: The risk of RRD is lower in eyes that required PPV for DNLF than in eyes that were managed with AV alone following PCR during cataract surgery. The poor visual outcomes in eyes that suffered RRD underscore the importance of postoperative retinal examination and early detection of retinal breaks.
基金Supported by the National Natural Science Foundation of China(No.81970813,No.81770967)the National Key R&D Program of China(No.2018YFC0116500)+1 种基金the Natural Science Foundation of Guangdong Province,China(No.2018A030313635)Science and Technology Program of Guangzhou,China(No.201904010062)。
文摘AIM:To compare the visual outcomes of children with small(≤3 mm)posterior polar cataracts(PPC)and posterior lenticonus who had cataract extraction surgery with the visual outcomes of those who were managed conservatively.METHODS:Children who initially had small PPC and posterior lenticonus who were followed up over 1-year period were retrospective reviewed in the study.Patients receiving surgery were compared with those receiving conservative therapy.The axial length,keratometry,refraction,bestcorrected visual acuity(BCVA),and strabismus measurements were recorded.Lens morphology,i.e.,the location,size,and depth of the cataract lesion,was measured with a Scheimpflug imaging system.To help control for baseline differences in the groups,patients were matched with controls by propensity score methodology.RESULTS:The study evaluated 60 patients(30 in the surgery group and 30 in the conservative therapy group)after matching by propensity score.Patients who underwent cataract surgery showed greater BCVA improvements(0.36±0.24 logMAR)than patients who were treated without surgery(0.22±0.26 logMAR;P=0.036).Surgery was effective in patients with a rear projection length(RPL)less than 1.0 mm and a pretreatment BCVA worse than 0.52 logMAR.CONCLUSION:Children with small PPC and posterior lenticonus who undergo cataract surgery experience greater BCVA improvements than those managed conservatively.Certain patients presenting with a RPL less than 1.0 mm and a pretreatment BCVA of 0.52 logMAR or worse may benefit from surgery.
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.
文摘Although cataract surgery in posterior polar cataract is associated with posterior capsular rent and nucleus drop, by taking precautions the rate of complication can be decreased. The aim of this article is to review the etiology, pathogenesis, clinical features, and management of posterior polar cataract.
基金Supported by the National Natural Science Foundation of China(No.81670837)the Scientific and Technological Project of Tianjin Health Bureau(No.2015KY38)
文摘AIM: To explore the effect of the posterior astigmatism on total corneal astigmatism and evaluate the error caused by substituting the corneal astigmatism of the simulated keratometriy (simulated K) for the total corneal astigmatism in age-related cataract patients. METHODS: A total of 211 eyes with age-related cataract from 164 patients (mean age: 66.8±9.0y, range: 45-83y) were examined using a multi-colored spot reflection topographer, and the total corneal astigmatism was measured. The power vector components J0 and J45 were analyzed. Correlations between the magnitude difference of the simulated K and total cornea astigmatism (magnitude differenceSimK-Tca), anterior J0, and absolute meridian difference (AMD) between the anterior and posterior astigmatisms were calculated. To compare the astigmatism of the simulated K and total cornea both in magnitude and axial orientation, we drew double-angle plots and calculated the vector difference between the two measures using vector analysis. A corrective regression formula was used to adjust the magnitude of the simulated K astigmatism to approach that of the total cornea. RESULTS: The magnitude differenceSimK-Tca was positively correlated with the anterior corneal J0 (Spearman’s rho= 0.539; P〈0.001) and negatively correlated with the AMDR (Spearman’s rho=-0.875, P〈0.001). When the anterior J0 value was larger than 1.3 D or smaller than -0.8 D, the errors caused by determining the total corneal astigmatism with the karatometric calculation tended to be greater than 0.25 D. An underestimation by 16% was observed for against the rule (ATR) astigmatism and an overestimation by 9% was observed for with the rule (WTR) astigmatism when ignoring the posterior measurements. CONCLUSION: Posterior corneal astigmatism should be valued for more precise corneal astigmatism management, especially for higher ATR astigmatism of the anterior corneal surface. We suggest a 9% reduction in the magnitude of the simulated K in eyes with WTR astigmatism, and a 16% addition of the magnitude of the simulated K in eyes with ATR astigmatism.
文摘Twenty-five cases of posterior chamber IOL implantation intraumatic cataract with complications associated with primary injury werereported.The operating methods were described and the post-operative com-plications were discussed.Seventy-two percent of patients have the correctvision over 20/40.It is suggested that the posterior chamber IOL can be im-planted in traumatic cataract with some injured complications.EYE SCIENCE1992;8:111-112.
文摘Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.
文摘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.
文摘AIMTo compare the effectiveness and safety of pars plana capsulotomy and vitrectomy using 25-gauge tansconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system for posterior capsule opacification (PCO) in pseudophakic children.METHODSRetrospectively study. Pars plana capsulotomy and vitrectomy using 25-gauge sutureless vitrectomy system was performed for PCO in the study group (32 eyes). Patients in the control group (34 eyes) underwent capsulotomy and vitrectomy using standard 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), and intraoperative and postoperative complications. The two groups were performed consequentially. The patients ages ranged from 2 to 13y (means: 6.61±2.73y). Surgical technique, intraoperative and postoperative complications, visual acuity, IOP, and recurrent PCO were recorded.RESULTSThe surgical procedure was performed uneventfully in all patients. Visual acuity improved significantly in both groups. BCVA improved in 22 eyes (81.5%) in the study group and in 28 eyes (87.5%) in the control group. There was no statistical difference of visual acuity that were attainable in two groups (H=0.115, P=0.909). Mean postoperative IOP showed no significant difference between the groups at 1wk. All sort of PCO were accomplished by 20-gauge system, while 25-gauge system was effective for pearls style and 2 grade of fibrous PCO, and was insufficient to grade 3 of PCO. In the study group two cases were not accomplished by 25-gauge system while 20-gauge system conquered them. Compared with the control group, mean operative time for opening and closing the sclerotomy in the study group was considerably reduced. The mean follow-up was 38.2mo (range: 8-79mo). During the follow-up period, no incision leakage, corneal edema, vitreous loss, IOL damage, retinal detachment, recurrent PCO, or other complications were noted.CONCLUSIONPars plana capsulotomy and vitrectomy using 25-gauge transconjunctival sutureless vitrectomy appeared to be a safe and effective approach for PCO in pseudophakic children. Combined sutureless surgery needed shorter setup time for sclerotomy and caused less surgical trauma than combined surgery with 20-gauge vitrectomy. Therefore, this type of procedure would be a good option for selected cases with PCO in pseudophakic children.
文摘AIM:To investigate the effects of a new opening pattern in neodymium:yttrium-aluminum-garnet(Nd:YAG)laser posterior capsulotomy on visual function.METHODS:This technique was conducted along a circular pattern.The energy ranged between 0.8 and1.2 mJ/pulse was consumed and mean total energy levels were 74±21 mJ(mean±standard deviation:SD,from 40 to167)and laser shots aimed at 150μm away behind a datum point and went along an imaginary line which extends 0.5 mm inside from optic margin and into the circular en bloc pattern.Vitreous stands were attached with fragment and then they were cut off by the laser after circular application.The circular fragment was completely separated from vitreous,and then this fragment was quickly sunk in intravitreal space.RESULTS:The follow-up period ranges from at least a week to 40mo,making 15.8mo on average.The procedural outcome showed 96%(74 eyes out of the 77eyes)enhancement in patients’visual acuity.Cystoid macular edema or retinal detachment was not observed in any of the patients during follow-up periods.CONCLUSION:This new technique is expected to improve the weaknesses that the conventional procedures have by adding the process to cut off vitreous stands attached with the fragment by the laser to the circular application.
文摘BACKGROUND Hypoparathyroidism is uncommon,and cataracts secondary to hypoparathyroidism are even rarer.Herein,we report a case of bilateral cataracts following hypoparathyroidism.CASE SUMMARY A 27-year-old man presented to our hospital because of painless and progressive visual impairment of both eyes over two years.He was previously diagnosed with hypocalcemia but did not take calcium supplements regularly.He had no history of anterior neck thyroid surgery.After admission,the biochemical analysis indicated a serum calcium level of 1.21 mmol/L and an intact parathyroid hormone level of 0 pg/mL.Ocular examination revealed bilateral symmetrical opacity of the lens presenting as punctate opacity in the posterior subcapsular cortex together with radial opacity in the peripheral cortex(N1C2P3).Phacoemulsification with an intraocular lens was performed in both eyes sequentially.Postoperatively,the patient had a satisfactory recovery and greatly improved visual acuity.CONCLUSION This patient had hypocalcemia owing to idiopathic parathyroid insufficiency.Hypoparathyroidism may go unnoticed for years but with some latent clinical manifestations,such as bilateral symmetrical posterior subcapsular cataracts.This case report highlights that the cause of hypocalcemia in particularly young patients should be further investigated.Clinicians should be aware of hypoparathyroidism as a cause of bilateral cataracts.Early identification of hypoparathyroidism can save patients from further complications.