BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical sign...BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical significance.AIM To explore the clinical effect of recombinant human epidermal growth factor(rhEGF)plus sodium hyaluronate(SH)eye drops on DES after cataract surgery in patients with diabetes.METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital,Affiliated Hospital of Nankai University between April 2021 and April 2023.They were classified into an observation group(42 cases,rhEGF+SH eye drops)and a control group(40 cases,SH eye drops alone),depending on the different treatment schemes.The therapeutic efficacy,dry eye symptom score,tear film breakup time(TFBUT),basic tear secretion score[assessed using Schirmer I test(SIt)],corneal fluorescein staining(FL)score,tear inflammatory markers,adverse reactions during treat-ment,and treatment satisfaction were compared between the two groups.RESULTS Therapeutic efficacy was higher in the observation group compared with the control group.Both groups showed improved TFBUT and dry eye,as well as improved SIt and FL scores after treatment,with a more pronounced improvement in the observation group.Although no marked differences in adverse reactions were observed between the two groups,treatment satisfaction was higher in the observation group.CONCLUSION rhEGF+SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy,fewer adverse reactions,and high safety levels.Thus,this treatment should be promoted in clinical practice.展开更多
Objective:To evaluate the therapeutic effect of recombinant bovine basic fibroblast growth factor(rbFGF)eye gel combined with tobramycin-dexamethasone(TOB-Dex)eye drops on dry eye syndrome(DES)after cataract surgery.M...Objective:To evaluate the therapeutic effect of recombinant bovine basic fibroblast growth factor(rbFGF)eye gel combined with tobramycin-dexamethasone(TOB-Dex)eye drops on dry eye syndrome(DES)after cataract surgery.Methods:86 patients with DES after cataract surgery,admitted from November 2021 to November 2023,were randomly divided into groups.The observation group included 43 patients treated with rbFGF eye gel combined with TOB-Dex eye drops.The reference group included 43 patients treated with TOB-Dex eye drops alone.Multiple indicators,including total effective rate and clinical symptom scores,were compared between the two groups.Results:The total effective rate in the observation group was higher than in the reference group(P<0.05).Before treatment,there were no differences in clinical symptom scores,serum factors,or disease severity scores between the two groups(P>0.05).Three weeks after treatment,the observation group had lower clinical symptom scores,serum factors,and disease severity scores compared to the reference group(P<0.05).The adverse reaction rate in the observation group was lower than in the reference group(P<0.05).Conclusion:rbFGF eye gel combined with TOB-Dex eye drops can improve the clinical efficacy for patients with DES after cataract surgery,alleviate disease symptoms,reduce inflammatory responses,and have fewer adverse reactions.展开更多
AIM:To investigate the influence of ophthalmic viscoelastic devices(OVDs)and different surgical approaches on the intraocular pressure(IOP)before and after creation of the curvilinear circular capsulorhexis(CCC)as a m...AIM:To investigate the influence of ophthalmic viscoelastic devices(OVDs)and different surgical approaches on the intraocular pressure(IOP)before and after creation of the curvilinear circular capsulorhexis(CCC)as a measure for anterior chamber stability during this maneuver.METHODS:Prospective experimental WetLab study carried out on enucleated porcine eyes.IOP was measured before and after CCC with the iCare Rebound tonometer(iCare ic200;iCare Finland Oy,Vantaa,Finland).The OVDs used were a cohesive one[Z-Hyalin,Carl Zeiss Meditec AG,Germany;hyaluronic acid(HA)]and a dispersive[Z-Celcoat,Carl Zeiss Meditec AG,Germany;hydroxy propylmethylcellulosis(HPMC)].The CCC was created using Utrata forceps or 23 g microforceps in different combinations with the OVDs.RESULTS:Using the Utrata forceps the IOP dropped from 63.65±6.44 to 11.25±3.63 mm Hg during the CCC.The use of different OVDs made no difference.Using the 23 g microforceps the IOP dropped from 65.35±8.15 to 36.55±6.09 mm Hg.The difference between IOP drop using either Utrata forceps or 23 g microforceps was highly significant regardless of the OVD used.CONCLUSION:Using the sideport for the creation of the capsulorhexis leads to a lesser drop in IOP during this maneuver compared to the main incision in enucleated porcine eyes.The use of different OVD has no significant influence on IOP drop.展开更多
AIM: To observe the changes in ocular surface and the dry eye symptoms following femtosecond laser-assisted cataract surgery(FLACS). METHODS: Patients with no eye signs or symptoms in Guangzhou Aier Eye Hospital betwe...AIM: To observe the changes in ocular surface and the dry eye symptoms following femtosecond laser-assisted cataract surgery(FLACS). METHODS: Patients with no eye signs or symptoms in Guangzhou Aier Eye Hospital between October 2017 and September 2018, who underwent FLACS and intraocular lens(IOL) implantation for age-related cataract were enrolled. Tear film stability assessed with OCULUS Keratograph 5 M, Schirmer’s I test(SIT), and corneal fluorescein staining(CFS) were evaluated before and after surgery at 1 d, 1 wk, 1, and 3 mo in order. Ocular Surface Disease Index scores(OSDI) and Subjective Symptom Questionnaires(SSQs) were recorded at the same time point.RESULTS: Thirty-eight eyes of 38 patients were enrolled. The noninvasive tear film break-up time(first break-up time and average break-up time) decreased in a peak at the 1 wk visit, and then increased to basic levels at 1 mo. The tear meniscus height(TMH) increased transiently at 1 d, and declined in the following 3 mo visits. The SIT had a transient increase at 1 d(P=0.357) and a decrease at 1 wk and 1 mo(both P<0.05) but returned to the preoperative levels at 3 mo after surgery(P=0.062). CFS scores were significantly improved compared with those before surgery, and had a statistical difference(P<0.05). OSDI scores and SSQs after surgery were obviously higher, and had a statistical difference(P<0.001) but didn’t return to the basic level by 3 mo. CONCLUSION: Dry eye signs and symptoms can occur immediately following FLACS and have a peak severity on day 7 postoperatively. Most signs of dry eye can return to preoperative basic levels within 3 mo postoperatively. However, all cases can not recover from CFS and dry eye symptoms at 3 mo postoperatively.展开更多
AIM: To investigate the incidence of preoperative dry eye and related factors in patients undergoing corneal refractive surgery to correct myopia.METHODS: A total of 141 patients with myopia who underwent corneal refr...AIM: To investigate the incidence of preoperative dry eye and related factors in patients undergoing corneal refractive surgery to correct myopia.METHODS: A total of 141 patients with myopia who underwent corneal refractive surgery were surveyed by questionnaires, tear film break-up time(BUT) test, Schimer I test(SIt), corneal fluorescein staining(FL) test and diagnosed according to the currently recognized domestic diagnostic criteria for dry eye. Correlation analysis of factors such as age, gender, regular wearing of contact lens(CL), diopter(spherical equivalent), corneal thickness, and corneal curvature that may affect the onset of dry eye was carried out to clarify the main influencing factors. RESULTS: There were 64 patients(45.39%) diagnosed with dry eye. The male patients(20.31%) was significantly less than that of non-dry eye subjects(41.56%;χ~2=7.260, P=0.007);the proportion of patients with dry eye wearing CL(81.25%) was significantly higher than that of non-dry eye subjects(51.95%;χ~2=13.234, P<0.001);the median diopter level of dry eye patients was-6.59(IQR:-8.87,-4.58) D, and the median diopter level of non-dry eye subjects was-5.69(IQR:-7.15,-4.03) D. The diopter level of dry eye patients was significantly higher(Z=-2.086, P=0.019). However, the age, best corrected visual acuity, and intraocular pressure of dry eye patients were not statistically different from those of non-dry eye subjects(t=-0.257,-0.383 and 0.778, P=0.798, 0.702, and 0.438);the corneal thickness and corneal curvature(K1 and K2) were also not statistically different either(Z=-1.487,-1.036 and-1.707, P=0.137, 0.300, and 0.088). The research further analyzes the three significant factors in the single factor analysis(gender, CL wear, and diopter) in a multi-factor way: CL wear and diopter were the influencing factors of dry eye disease. Among them, CL wear increased the risk of dry eye by 2.934 times compared with no CL wear;for every 1 D increase in diopter, the risk of dry eye increased by 0.761 times.CONCLUSION: Preoperative dry eye is relatively common in patients who undergo corneal refractive surgery to correct myopia, especially in patients who have a history of CL wear and a high diopter level before surgery. Therefore, it is necessary to carry out preoperative screening and timely treatment of dry eye to obtain the best treatment outcome and postoperative satisfaction.展开更多
【正】Dear Sir,Iam Yong-Sun Ahn,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.Cataracts are a common problem in eyes with a glaucoma drainage device(GDD),because tube shun...【正】Dear Sir,Iam Yong-Sun Ahn,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.Cataracts are a common problem in eyes with a glaucoma drainage device(GDD),because tube shunt surgery increases the incidence and progression of cataracts[1].An Ahmed valve,the most commonly inserted GDD,is composed of a silicone tube connected to a flat plate sewn to the sclera,and aqueous humor flows from the展开更多
Dear Sir,It is known that cataract surgery is challenging in vitrectomized eyes.Cataract surgeons may have encountered with posterior capsular complications and nucleus drop events even with minimal ocular manipulatio...Dear Sir,It is known that cataract surgery is challenging in vitrectomized eyes.Cataract surgeons may have encountered with posterior capsular complications and nucleus drop events even with minimal ocular manipulations and low irrigation bottle height.Inadvertent damage to the zonular fibers,posterior or peripheral lens capsule with ocutome or microvitreoretinal(MVR)blade in previous展开更多
Eyelid surgery is widely and extensively used in facial plastic and reconstructive surgeries.There are many categories of eyelid surgeries,the most common of which include blepharoplasty,ptosis surgery,and eyelid reco...Eyelid surgery is widely and extensively used in facial plastic and reconstructive surgeries.There are many categories of eyelid surgeries,the most common of which include blepharoplasty,ptosis surgery,and eyelid reconstruction.In many cases,these procedures are combined,and there are many different techniques for each type of operation.Upper eyelid blepharoplasty usually includes the excision of skin,preseptal orbicularis oculi muscle,and orbital fat.Common methods of lower eyelid blepharoplasty are the skin-muscle flap,the skin flap,and the transconjunctival.Ptosis surgery is mainly divided into three types:transcutaneous,transconjunctival,and sling surgery.Surgeons often used the Hughes or Cutler-Beard Bridge Flaps in eyelid reconstruction.Different types and methods of surgery have their own advantages and disadvantages,and postoperative complications may occur.Therefore,postoperative complications of eyelid surgeries,such as dry eye symptoms,should be taken into serious consideration.Relevant literature involving these complaints can be found in PubMed by searching the terms“dry eye”,“eyelid”,“surgery”,and other related keywords.Moreover,various ocular surface and tear film alterations may be detected using the Ocular Surface Disease Index(OSDI),tear film breakup time,Schirmer test,fluorescein staining,and lissamine green staining after various eyelid surgeries.As dry eye disease is prevalent in the general population,it is more urgent to figure out what we can learn from these complaints.Further exploration in this field may help surgeons to choose a better surgical method and give an accurate evaluation of the postoperative effect.展开更多
BACKGROUND As one of the most common aesthetic surgical procedures carried out today,blepharoplasty should be in the repertoire of every plastic surgeon.The term blepharoplasty encompasses a wide range of techniques a...BACKGROUND As one of the most common aesthetic surgical procedures carried out today,blepharoplasty should be in the repertoire of every plastic surgeon.The term blepharoplasty encompasses a wide range of techniques and options that must be tailored to the specific defect and patient one has to treat.A sound knowledge of the upper and lower eyelids’anatomy is essential for proper surgical execution.Trends have shifted towards more conservative methods(especially of the fat compartment)and sometimes in combination with augmentation techniques,helping to reach a rejuvenated appearance.AIM To present an overview of the surgical techniques considered for upper lid blepharoplasty and fat pad management,in addition to information on how a surgeon may approach the best treatment for his patient based on current publications in literature.METHODS We searched the literature published between 2013,to 2023 using Medline and Reference Citation Analysis.The database was searched using the keywords“upper blepharoplasty”AND“fat”.Papers without full text/abstracts and reviews were excluded.The search strategy followed the PRISMA.The American Society of Plastic Surgeons guidelines for Therapeutic Studies checklist was used to assess all articles.Two authors individually reviewed each article and rated them for importance and relevance to the topic.A consensus was sought and the most relevant studies.RESULTS After the application of the selection criteria used in our review,13 publications were found to address upper lid blepharoplasty specifically.Three of these studies were reviews and three were retrospective studies.Five publications were comparative studies and a further two were clinical trials.CONCLUSION The tendency of modern surgery is to be conservative,by removing adipose tissue only if strictly necessary and restoring the volume of the upper eyelid in a concept of beauty that espouses a"full"sight.There is no gold standard technique to achieve younger and enhanced eyelids.Long-term prospective comparative studies are fundamental in understanding which path is the best to follow.展开更多
Laser refractive surgery is one of the most commonly performed procedures worldwide.In laser refractive surgery,Femtosecond Laser in Situ Keratomileusis and Refractive Lenticule Extraction have emerged as promising al...Laser refractive surgery is one of the most commonly performed procedures worldwide.In laser refractive surgery,Femtosecond Laser in Situ Keratomileusis and Refractive Lenticule Extraction have emerged as promising alternatives to microkeratome Laser in Situ Keratomileusis and Photorefractive Keratectomy.Following laser refractive surgery,the corneal nerves,epithelial and stromal cells release neuromediators,including neurotrophins,neuropeptides and neurotransmitters.Notably,nerve growth factor,substance P,calcitonin gene-related peptide and various cytokines are important mediators of neurogenic inflammation and corneal nerve regeneration.Alterations in neuromediator profiles and ocular surface parameters following laser refractive surgery are attributed to the surgical techniques and the severity of tissue insult induced.In this review,we will discuss the(1)Functions of neuromediators and their physiological and clinical significance;(2)Changes in the neuromediators following various laser refractive surgeries;(3)Correlation between neuromediators,ocular surface health and corneal nerve status;and(4)Future directions,including the use of neuromediators as potential biomarkers for ocular surface health following laser refractive surgery,and as adjuncts to aid in corneal regeneration after laser refractive surgery.展开更多
AIM:To report the incidence,risk factors and visual outcomes for postoperative endophthalmitis(POE)based on 7-year data from the Malaysian Ministry of Health Cataract Surgery Registry(MOH CSR).METHODS:Data was c...AIM:To report the incidence,risk factors and visual outcomes for postoperative endophthalmitis(POE)based on 7-year data from the Malaysian Ministry of Health Cataract Surgery Registry(MOH CSR).METHODS:Data was collected from the web-based MOH CSR.All consecutive cataract surgery patients from 1st June 2008 to 31st December 2014 were identified.Exclusion criteria were traumatic cataract or previous ocular surgery.Demographic data,ocular co-morbidities,intraoperative details and postoperative visual acuity(VA)at final ophthalmological follow-up were noted.All eyes were taken for analysis.Subjects with POE were compared against subjects with no POE for risk factor assessment using multiple logistic regressions.RESULTS:A total of 163 503 subjects were screened.The incidence of POE was 0.08%(131/163 503).Demographic POE risk factors included male gender(OR:2.121,95%CI:1.464-3.015)and renal disease(OR:2.867,95%CI:1.503-5.467).POE risk increased with secondary causes of cataract(OR:3.562,95%CI:1.740-7.288),uveitis(OR:11.663,95%CI:4.292-31.693)and diabetic retinopathy(OR:1.720,95%CI:1.078-2.744).Intraoperative factors reducing POE were shorter surgical time(OR:2.114,95%CI:1.473-3.032),topical or intracameral anaesthesia(OR:1.823,95%CI:1.278-2.602),posterior chamber intraocular lens(PCIOL;OR:4.992,95%CI:2.689-9.266)and foldable IOL(OR:2.276,95%CI:1.498-3.457).POE risk increased with posterior capsule rupture(OR:3.773,95%CI:1.915-7.432)and vitreous loss(OR:3.907,95%CI:1.720-8.873).Postoperative VA of 6/12 or better was achieved in 15.27%(20/131)subjects with POE.CONCLUSION:This study concurs with other studies regarding POE risk factors.Further strengthening of MOH CSR data collection process will enable deeper analysis and optimization of POE treatment.展开更多
BACKGROUND Heavy eye syndrome(HES)is an acquired strabismus typically seen in eyes with high myopia.We report a classic case in which a patient was misdiagnosed with esotropia and underwent disinsertion of the medial ...BACKGROUND Heavy eye syndrome(HES)is an acquired strabismus typically seen in eyes with high myopia.We report a classic case in which a patient was misdiagnosed with esotropia and underwent disinsertion of the medial rectus muscle and lateral rectus muscle resection procedures.CASE SUMMARY A 71-year-old woman presented with both eyes fixed in adduction and infraduction for 33 years.She had undergone three complicated strabismus surgeries to amputate the left medial rectus(MR)muscle with lateral rectus muscle recession,but no improvement in the esotropia appeared after each operation.She was diagnosed with HES and underwent a bilateral Yokoyama procedure and recession of the right MR muscle under general anesthesia.After surgery,her eyes were binocularly aligned for 6 mo.This case suggests that pertinacious esotropia combined with high myopia must be considered in HES.Orbital imaging and ultrasonography can demonstrate anatomical abnormality and mu-scle paths to confirm a definite diagnosis.CONCLUSION The Yokoyama procedure was effective in correcting HES.展开更多
AIM: To investigate the relationship between China's first Western-style eye hospital development and the prevention of blindness in China and determine the main factor influencing eye health today. METHODS: Data ...AIM: To investigate the relationship between China's first Western-style eye hospital development and the prevention of blindness in China and determine the main factor influencing eye health today. METHODS: Data about eye health, blindness and cataract surgery rate of China from public website of World Health Organization (WHO), ORBIS International, Ministry of Health (MOH) of China, Pubmed center and Historical Archives of Zhongshan Ophthalmic Center (ZOC) were reviewed and analyzed. RESULTS: ZOC is China's first Western-style eye hospital. In 2012, the ORBIS Flying Eye Hospital has chosen ZOC once again as one of its destinations, 30 years after ORBIS expanded internationally to train eye care professionals and treat underserved patients in developing countries in 1982. During the past 30 years, cataract surgery rate and public awareness of blindness prevention were improved greatly in China, in which ZOC plays a very important role. CONCLUSION: ZOC, as China's first Western-style eye hospital,has improved in the prevention of blindness. Eye health has become everyone’s responsibility.展开更多
Navigation technology in ophthalmology,colloquially called“eye-tracking”,has been applied to various areas of eye care.This approach encompasses motion-based navigation technology in both ophthalmic imaging and trea...Navigation technology in ophthalmology,colloquially called“eye-tracking”,has been applied to various areas of eye care.This approach encompasses motion-based navigation technology in both ophthalmic imaging and treatment.For instance,modern imaging instruments use a real-time eye-tracking system,which helps to reduce motion artefacts and increase signal-to-noise ratio in imaging acquisition such as optical coherence tomography(OCT),microperimetry,and fluorescence and color imaging.Navigation in ophthalmic surgery has been firstly applied in laser vision corrective surgery and spread to involve navigated retinal photocoagulation,and positioning guidance of intraocular lenses(IOL)during cataract surgery.It has emerged as one of the most reliable representatives of technology as it continues to transform surgical interventions into safer,more standardized,and more predictable procedures with better outcomes.Eye-tracking is essential in refractive surgery with excimer laser ablation.Using this technology for cataract surgery in patients with high preoperative astigmatism has produced better therapeutic outcomes.Navigated retinal laser has proven to be safer and more accurate compared to the use of conventional slit lamp lasers.Eye-tracking has also been used in imaging diagnostics,where it is essential for proper alignment of captured zones of interest and accurate follow-up imaging.This technology is not routinely discussed in the ophthalmic literature even though it has been truly impactful in our clinical practice and represents a small revolution in ophthalmology.展开更多
This study was to estimate refractive status of the second eye of those undergo bilateral cataract surgery based on the first-operated eye, and to evaluate the refractive error(RE) in the second eye after correcting 5...This study was to estimate refractive status of the second eye of those undergo bilateral cataract surgery based on the first-operated eye, and to evaluate the refractive error(RE) in the second eye after correcting 50% of the first-operated eye’s error when it exceeded ±0.50 diopter(D). In this prospective study, 80 patients were scheduled for cataract surgery in the second eye, who underwent cataract surgery in first eye 1-3 mo previously. The RE of each eye postoperatively was determined according to SRK/T formula. When the first-eye refractive error(FERE) exceeded ±0.5 D, the intraocular lens(IOL) power of the second eye was adjusted 50% of the FERE. The second-eye refractive error(SERE) was measured 1 mo after surgery. The FERE exceeded-0.50 D in 12 eyes(-0.675±0.16 D), and the adjusted SERE was-0.322±0.73 D(P<0.05). The FERE exceeded +0.50 D in 8 eyes(1.533±1.14 D),and the adjusted SERE was 0.168±1.36 D(P<0.05). The unadjusted SERE in 60 cases remained-0.38 to 0.42 D when the FERE within ±0.05 D. This prospective study confirmed that the prediction of the second eye could be improved by correcting 50% of FERE when this error exceeded ±0.50 D.展开更多
Aim: To evaluate results of cataract surgery in Eye Camp in rural areas. Patients and Method: This study set about the retrospective analysis of cases and operating reports of patients over the age of 10, operated for...Aim: To evaluate results of cataract surgery in Eye Camp in rural areas. Patients and Method: This study set about the retrospective analysis of cases and operating reports of patients over the age of 10, operated for cataract in Eye Camp and fixed strategy from January, 2010 to December, 2012. Postoperative data were specified and compared. Results: Out of a total of 1145 patients operated, 577 (50.40%) were men compared with 568 (49.60%) women. The general mean age was 62 years, similar in Eye Camp and in fixed strategy. Sixty percent of patients were operated in Eye Camp. After 4 weeks of follow-up, 77% of patients were met again, and 83% among them showed good results (corrected visual acuity = 3/10). This rate of good results was 80.43% in Eye Camp against 87.7% in fixed strategy. We noted 18.25% of complications among which 11.25% were in Eye Camp. The functional outcomes of both strategies get closer to WHO standards. Conclusion: Eye Camp in the Central Region of Togo is an interesting alternative that contributes to the fight against blindness, even if postoperative follow-up is still to be improved.展开更多
Introduction: Dry eye disease is currently considered mainly tear film related ocular surface condition. This concept does, however, not respect ocular surface topography. The micro-anatomy of the corneal changes may ...Introduction: Dry eye disease is currently considered mainly tear film related ocular surface condition. This concept does, however, not respect ocular surface topography. The micro-anatomy of the corneal changes may lead to enhanced demands on the tear film and lead to significant complaints. However, they often remain undetected and hence untreated. It is suggested that the pathophysiology for an entire subgroup of dry eye disease patients is primarily of surface morphological nature. Methods: The tear film break up was observed and used to identify anatomical alterations in eyes of patients with dry eye complaints. The localization and pattern of TFBUT using fluorescein was compared between eye with normal surfaces and surface alterations. Results: Premature tear film rupture was localized at constantly same areas and did match changes on the ocular epitheliopathy in patients with diseases such as microcystic epithliopathy, MFD, and after excimer laser treatment. Disusssion: Whereas in normal surfaces TFBUT does occur within the floating tear film, the anatomical dry eye identifies itself with constant location of tear film break up and a constant spreading pattern. In contrast to the classic, tear film caused dry eye, the anatomical dry eye is accessible to treatment. This should catch our attention and intent to identify it. It is the ease of possible treatment that should make these ocular surface alterations prime target of dry eye disease diagnostic. It is hence suggested to introduce the anatomical dry eye as a subgroup in the large group of dry eye and ocular surface disease.展开更多
s from those searches were screened for relevance to our review topics.Publications were included if the subjects included glaucoma patients,and if ocular surface outcomes were described.Non-English papers were exclud...s from those searches were screened for relevance to our review topics.Publications were included if the subjects included glaucoma patients,and if ocular surface outcomes were described.Non-English papers were excluded.Key Content and Findings:Topical glaucoma medications frequently cause adverse effects on the ocular surface,both through direct action of the medications themselves as well as through toxicity from their associated preservatives.Optimization of the ocular surface may improve medication compliance rates.Traditional surgical treatments for glaucoma,such as trabeculectomy,can exacerbate OSD by disrupting the ocular surface but can also reduce the need for chronic medications.Optimization of ocular surface health is imperative in reducing trabeculectomy complication rates,while also potentially reducing the need for trabeculectomy in patients that are able to achieve intraocular pressure control through improved drop tolerability.The introduction of MIGS represents a promising alternative to existing therapies and has been shown to alleviate the overall medication burden.It would be reasonable to assume that decreasing the medication burden could reduce OSD prevalence and severity.However,more research is needed to directly assess the extent of improvement seen after MIGS.Conclusions:A comprehensive understanding of the importance of OSD in medical and surgical management of glaucoma is essential in optimizing patient care and improving outcomes.展开更多
基金Supported by Tianjin Health Research Project,No.TJWJ2023MS062。
文摘BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical significance.AIM To explore the clinical effect of recombinant human epidermal growth factor(rhEGF)plus sodium hyaluronate(SH)eye drops on DES after cataract surgery in patients with diabetes.METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital,Affiliated Hospital of Nankai University between April 2021 and April 2023.They were classified into an observation group(42 cases,rhEGF+SH eye drops)and a control group(40 cases,SH eye drops alone),depending on the different treatment schemes.The therapeutic efficacy,dry eye symptom score,tear film breakup time(TFBUT),basic tear secretion score[assessed using Schirmer I test(SIt)],corneal fluorescein staining(FL)score,tear inflammatory markers,adverse reactions during treat-ment,and treatment satisfaction were compared between the two groups.RESULTS Therapeutic efficacy was higher in the observation group compared with the control group.Both groups showed improved TFBUT and dry eye,as well as improved SIt and FL scores after treatment,with a more pronounced improvement in the observation group.Although no marked differences in adverse reactions were observed between the two groups,treatment satisfaction was higher in the observation group.CONCLUSION rhEGF+SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy,fewer adverse reactions,and high safety levels.Thus,this treatment should be promoted in clinical practice.
文摘Objective:To evaluate the therapeutic effect of recombinant bovine basic fibroblast growth factor(rbFGF)eye gel combined with tobramycin-dexamethasone(TOB-Dex)eye drops on dry eye syndrome(DES)after cataract surgery.Methods:86 patients with DES after cataract surgery,admitted from November 2021 to November 2023,were randomly divided into groups.The observation group included 43 patients treated with rbFGF eye gel combined with TOB-Dex eye drops.The reference group included 43 patients treated with TOB-Dex eye drops alone.Multiple indicators,including total effective rate and clinical symptom scores,were compared between the two groups.Results:The total effective rate in the observation group was higher than in the reference group(P<0.05).Before treatment,there were no differences in clinical symptom scores,serum factors,or disease severity scores between the two groups(P>0.05).Three weeks after treatment,the observation group had lower clinical symptom scores,serum factors,and disease severity scores compared to the reference group(P<0.05).The adverse reaction rate in the observation group was lower than in the reference group(P<0.05).Conclusion:rbFGF eye gel combined with TOB-Dex eye drops can improve the clinical efficacy for patients with DES after cataract surgery,alleviate disease symptoms,reduce inflammatory responses,and have fewer adverse reactions.
文摘AIM:To investigate the influence of ophthalmic viscoelastic devices(OVDs)and different surgical approaches on the intraocular pressure(IOP)before and after creation of the curvilinear circular capsulorhexis(CCC)as a measure for anterior chamber stability during this maneuver.METHODS:Prospective experimental WetLab study carried out on enucleated porcine eyes.IOP was measured before and after CCC with the iCare Rebound tonometer(iCare ic200;iCare Finland Oy,Vantaa,Finland).The OVDs used were a cohesive one[Z-Hyalin,Carl Zeiss Meditec AG,Germany;hyaluronic acid(HA)]and a dispersive[Z-Celcoat,Carl Zeiss Meditec AG,Germany;hydroxy propylmethylcellulosis(HPMC)].The CCC was created using Utrata forceps or 23 g microforceps in different combinations with the OVDs.RESULTS:Using the Utrata forceps the IOP dropped from 63.65±6.44 to 11.25±3.63 mm Hg during the CCC.The use of different OVDs made no difference.Using the 23 g microforceps the IOP dropped from 65.35±8.15 to 36.55±6.09 mm Hg.The difference between IOP drop using either Utrata forceps or 23 g microforceps was highly significant regardless of the OVD used.CONCLUSION:Using the sideport for the creation of the capsulorhexis leads to a lesser drop in IOP during this maneuver compared to the main incision in enucleated porcine eyes.The use of different OVD has no significant influence on IOP drop.
基金Supported by Medical Science and Technology Research Foundation Project of Guangdong Province(No.C2017029)Science and Technology Project of Yuexiu District,Guangzhou(No.2017-WS-013)
文摘AIM: To observe the changes in ocular surface and the dry eye symptoms following femtosecond laser-assisted cataract surgery(FLACS). METHODS: Patients with no eye signs or symptoms in Guangzhou Aier Eye Hospital between October 2017 and September 2018, who underwent FLACS and intraocular lens(IOL) implantation for age-related cataract were enrolled. Tear film stability assessed with OCULUS Keratograph 5 M, Schirmer’s I test(SIT), and corneal fluorescein staining(CFS) were evaluated before and after surgery at 1 d, 1 wk, 1, and 3 mo in order. Ocular Surface Disease Index scores(OSDI) and Subjective Symptom Questionnaires(SSQs) were recorded at the same time point.RESULTS: Thirty-eight eyes of 38 patients were enrolled. The noninvasive tear film break-up time(first break-up time and average break-up time) decreased in a peak at the 1 wk visit, and then increased to basic levels at 1 mo. The tear meniscus height(TMH) increased transiently at 1 d, and declined in the following 3 mo visits. The SIT had a transient increase at 1 d(P=0.357) and a decrease at 1 wk and 1 mo(both P<0.05) but returned to the preoperative levels at 3 mo after surgery(P=0.062). CFS scores were significantly improved compared with those before surgery, and had a statistical difference(P<0.05). OSDI scores and SSQs after surgery were obviously higher, and had a statistical difference(P<0.001) but didn’t return to the basic level by 3 mo. CONCLUSION: Dry eye signs and symptoms can occur immediately following FLACS and have a peak severity on day 7 postoperatively. Most signs of dry eye can return to preoperative basic levels within 3 mo postoperatively. However, all cases can not recover from CFS and dry eye symptoms at 3 mo postoperatively.
文摘AIM: To investigate the incidence of preoperative dry eye and related factors in patients undergoing corneal refractive surgery to correct myopia.METHODS: A total of 141 patients with myopia who underwent corneal refractive surgery were surveyed by questionnaires, tear film break-up time(BUT) test, Schimer I test(SIt), corneal fluorescein staining(FL) test and diagnosed according to the currently recognized domestic diagnostic criteria for dry eye. Correlation analysis of factors such as age, gender, regular wearing of contact lens(CL), diopter(spherical equivalent), corneal thickness, and corneal curvature that may affect the onset of dry eye was carried out to clarify the main influencing factors. RESULTS: There were 64 patients(45.39%) diagnosed with dry eye. The male patients(20.31%) was significantly less than that of non-dry eye subjects(41.56%;χ~2=7.260, P=0.007);the proportion of patients with dry eye wearing CL(81.25%) was significantly higher than that of non-dry eye subjects(51.95%;χ~2=13.234, P<0.001);the median diopter level of dry eye patients was-6.59(IQR:-8.87,-4.58) D, and the median diopter level of non-dry eye subjects was-5.69(IQR:-7.15,-4.03) D. The diopter level of dry eye patients was significantly higher(Z=-2.086, P=0.019). However, the age, best corrected visual acuity, and intraocular pressure of dry eye patients were not statistically different from those of non-dry eye subjects(t=-0.257,-0.383 and 0.778, P=0.798, 0.702, and 0.438);the corneal thickness and corneal curvature(K1 and K2) were also not statistically different either(Z=-1.487,-1.036 and-1.707, P=0.137, 0.300, and 0.088). The research further analyzes the three significant factors in the single factor analysis(gender, CL wear, and diopter) in a multi-factor way: CL wear and diopter were the influencing factors of dry eye disease. Among them, CL wear increased the risk of dry eye by 2.934 times compared with no CL wear;for every 1 D increase in diopter, the risk of dry eye increased by 0.761 times.CONCLUSION: Preoperative dry eye is relatively common in patients who undergo corneal refractive surgery to correct myopia, especially in patients who have a history of CL wear and a high diopter level before surgery. Therefore, it is necessary to carry out preoperative screening and timely treatment of dry eye to obtain the best treatment outcome and postoperative satisfaction.
文摘【正】Dear Sir,Iam Yong-Sun Ahn,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.Cataracts are a common problem in eyes with a glaucoma drainage device(GDD),because tube shunt surgery increases the incidence and progression of cataracts[1].An Ahmed valve,the most commonly inserted GDD,is composed of a silicone tube connected to a flat plate sewn to the sclera,and aqueous humor flows from the
文摘Dear Sir,It is known that cataract surgery is challenging in vitrectomized eyes.Cataract surgeons may have encountered with posterior capsular complications and nucleus drop events even with minimal ocular manipulations and low irrigation bottle height.Inadvertent damage to the zonular fibers,posterior or peripheral lens capsule with ocutome or microvitreoretinal(MVR)blade in previous
基金This study was supported by the State Scholarship Fund from China Scholarship Council,China(No.202008080258).
文摘Eyelid surgery is widely and extensively used in facial plastic and reconstructive surgeries.There are many categories of eyelid surgeries,the most common of which include blepharoplasty,ptosis surgery,and eyelid reconstruction.In many cases,these procedures are combined,and there are many different techniques for each type of operation.Upper eyelid blepharoplasty usually includes the excision of skin,preseptal orbicularis oculi muscle,and orbital fat.Common methods of lower eyelid blepharoplasty are the skin-muscle flap,the skin flap,and the transconjunctival.Ptosis surgery is mainly divided into three types:transcutaneous,transconjunctival,and sling surgery.Surgeons often used the Hughes or Cutler-Beard Bridge Flaps in eyelid reconstruction.Different types and methods of surgery have their own advantages and disadvantages,and postoperative complications may occur.Therefore,postoperative complications of eyelid surgeries,such as dry eye symptoms,should be taken into serious consideration.Relevant literature involving these complaints can be found in PubMed by searching the terms“dry eye”,“eyelid”,“surgery”,and other related keywords.Moreover,various ocular surface and tear film alterations may be detected using the Ocular Surface Disease Index(OSDI),tear film breakup time,Schirmer test,fluorescein staining,and lissamine green staining after various eyelid surgeries.As dry eye disease is prevalent in the general population,it is more urgent to figure out what we can learn from these complaints.Further exploration in this field may help surgeons to choose a better surgical method and give an accurate evaluation of the postoperative effect.
文摘BACKGROUND As one of the most common aesthetic surgical procedures carried out today,blepharoplasty should be in the repertoire of every plastic surgeon.The term blepharoplasty encompasses a wide range of techniques and options that must be tailored to the specific defect and patient one has to treat.A sound knowledge of the upper and lower eyelids’anatomy is essential for proper surgical execution.Trends have shifted towards more conservative methods(especially of the fat compartment)and sometimes in combination with augmentation techniques,helping to reach a rejuvenated appearance.AIM To present an overview of the surgical techniques considered for upper lid blepharoplasty and fat pad management,in addition to information on how a surgeon may approach the best treatment for his patient based on current publications in literature.METHODS We searched the literature published between 2013,to 2023 using Medline and Reference Citation Analysis.The database was searched using the keywords“upper blepharoplasty”AND“fat”.Papers without full text/abstracts and reviews were excluded.The search strategy followed the PRISMA.The American Society of Plastic Surgeons guidelines for Therapeutic Studies checklist was used to assess all articles.Two authors individually reviewed each article and rated them for importance and relevance to the topic.A consensus was sought and the most relevant studies.RESULTS After the application of the selection criteria used in our review,13 publications were found to address upper lid blepharoplasty specifically.Three of these studies were reviews and three were retrospective studies.Five publications were comparative studies and a further two were clinical trials.CONCLUSION The tendency of modern surgery is to be conservative,by removing adipose tissue only if strictly necessary and restoring the volume of the upper eyelid in a concept of beauty that espouses a"full"sight.There is no gold standard technique to achieve younger and enhanced eyelids.Long-term prospective comparative studies are fundamental in understanding which path is the best to follow.
文摘Laser refractive surgery is one of the most commonly performed procedures worldwide.In laser refractive surgery,Femtosecond Laser in Situ Keratomileusis and Refractive Lenticule Extraction have emerged as promising alternatives to microkeratome Laser in Situ Keratomileusis and Photorefractive Keratectomy.Following laser refractive surgery,the corneal nerves,epithelial and stromal cells release neuromediators,including neurotrophins,neuropeptides and neurotransmitters.Notably,nerve growth factor,substance P,calcitonin gene-related peptide and various cytokines are important mediators of neurogenic inflammation and corneal nerve regeneration.Alterations in neuromediator profiles and ocular surface parameters following laser refractive surgery are attributed to the surgical techniques and the severity of tissue insult induced.In this review,we will discuss the(1)Functions of neuromediators and their physiological and clinical significance;(2)Changes in the neuromediators following various laser refractive surgeries;(3)Correlation between neuromediators,ocular surface health and corneal nerve status;and(4)Future directions,including the use of neuromediators as potential biomarkers for ocular surface health following laser refractive surgery,and as adjuncts to aid in corneal regeneration after laser refractive surgery.
文摘AIM:To report the incidence,risk factors and visual outcomes for postoperative endophthalmitis(POE)based on 7-year data from the Malaysian Ministry of Health Cataract Surgery Registry(MOH CSR).METHODS:Data was collected from the web-based MOH CSR.All consecutive cataract surgery patients from 1st June 2008 to 31st December 2014 were identified.Exclusion criteria were traumatic cataract or previous ocular surgery.Demographic data,ocular co-morbidities,intraoperative details and postoperative visual acuity(VA)at final ophthalmological follow-up were noted.All eyes were taken for analysis.Subjects with POE were compared against subjects with no POE for risk factor assessment using multiple logistic regressions.RESULTS:A total of 163 503 subjects were screened.The incidence of POE was 0.08%(131/163 503).Demographic POE risk factors included male gender(OR:2.121,95%CI:1.464-3.015)and renal disease(OR:2.867,95%CI:1.503-5.467).POE risk increased with secondary causes of cataract(OR:3.562,95%CI:1.740-7.288),uveitis(OR:11.663,95%CI:4.292-31.693)and diabetic retinopathy(OR:1.720,95%CI:1.078-2.744).Intraoperative factors reducing POE were shorter surgical time(OR:2.114,95%CI:1.473-3.032),topical or intracameral anaesthesia(OR:1.823,95%CI:1.278-2.602),posterior chamber intraocular lens(PCIOL;OR:4.992,95%CI:2.689-9.266)and foldable IOL(OR:2.276,95%CI:1.498-3.457).POE risk increased with posterior capsule rupture(OR:3.773,95%CI:1.915-7.432)and vitreous loss(OR:3.907,95%CI:1.720-8.873).Postoperative VA of 6/12 or better was achieved in 15.27%(20/131)subjects with POE.CONCLUSION:This study concurs with other studies regarding POE risk factors.Further strengthening of MOH CSR data collection process will enable deeper analysis and optimization of POE treatment.
基金Supported by the Natural Science Foundation of Shandong Province,No.ZR2018BH013the China Postdoctoral Science Foundation,No.2017M612214.
文摘BACKGROUND Heavy eye syndrome(HES)is an acquired strabismus typically seen in eyes with high myopia.We report a classic case in which a patient was misdiagnosed with esotropia and underwent disinsertion of the medial rectus muscle and lateral rectus muscle resection procedures.CASE SUMMARY A 71-year-old woman presented with both eyes fixed in adduction and infraduction for 33 years.She had undergone three complicated strabismus surgeries to amputate the left medial rectus(MR)muscle with lateral rectus muscle recession,but no improvement in the esotropia appeared after each operation.She was diagnosed with HES and underwent a bilateral Yokoyama procedure and recession of the right MR muscle under general anesthesia.After surgery,her eyes were binocularly aligned for 6 mo.This case suggests that pertinacious esotropia combined with high myopia must be considered in HES.Orbital imaging and ultrasonography can demonstrate anatomical abnormality and mu-scle paths to confirm a definite diagnosis.CONCLUSION The Yokoyama procedure was effective in correcting HES.
基金Key Projects for Hospital Clinical Disciplines of the Ministry of Health of China in 2010-2012(Project No.175 in Document 439 of the Planning and Finance Secretary of Ministry of Health)
文摘AIM: To investigate the relationship between China's first Western-style eye hospital development and the prevention of blindness in China and determine the main factor influencing eye health today. METHODS: Data about eye health, blindness and cataract surgery rate of China from public website of World Health Organization (WHO), ORBIS International, Ministry of Health (MOH) of China, Pubmed center and Historical Archives of Zhongshan Ophthalmic Center (ZOC) were reviewed and analyzed. RESULTS: ZOC is China's first Western-style eye hospital. In 2012, the ORBIS Flying Eye Hospital has chosen ZOC once again as one of its destinations, 30 years after ORBIS expanded internationally to train eye care professionals and treat underserved patients in developing countries in 1982. During the past 30 years, cataract surgery rate and public awareness of blindness prevention were improved greatly in China, in which ZOC plays a very important role. CONCLUSION: ZOC, as China's first Western-style eye hospital,has improved in the prevention of blindness. Eye health has become everyone’s responsibility.
文摘Navigation technology in ophthalmology,colloquially called“eye-tracking”,has been applied to various areas of eye care.This approach encompasses motion-based navigation technology in both ophthalmic imaging and treatment.For instance,modern imaging instruments use a real-time eye-tracking system,which helps to reduce motion artefacts and increase signal-to-noise ratio in imaging acquisition such as optical coherence tomography(OCT),microperimetry,and fluorescence and color imaging.Navigation in ophthalmic surgery has been firstly applied in laser vision corrective surgery and spread to involve navigated retinal photocoagulation,and positioning guidance of intraocular lenses(IOL)during cataract surgery.It has emerged as one of the most reliable representatives of technology as it continues to transform surgical interventions into safer,more standardized,and more predictable procedures with better outcomes.Eye-tracking is essential in refractive surgery with excimer laser ablation.Using this technology for cataract surgery in patients with high preoperative astigmatism has produced better therapeutic outcomes.Navigated retinal laser has proven to be safer and more accurate compared to the use of conventional slit lamp lasers.Eye-tracking has also been used in imaging diagnostics,where it is essential for proper alignment of captured zones of interest and accurate follow-up imaging.This technology is not routinely discussed in the ophthalmic literature even though it has been truly impactful in our clinical practice and represents a small revolution in ophthalmology.
基金Supported by Natural Science Foundation of China (No.81300743)
文摘This study was to estimate refractive status of the second eye of those undergo bilateral cataract surgery based on the first-operated eye, and to evaluate the refractive error(RE) in the second eye after correcting 50% of the first-operated eye’s error when it exceeded ±0.50 diopter(D). In this prospective study, 80 patients were scheduled for cataract surgery in the second eye, who underwent cataract surgery in first eye 1-3 mo previously. The RE of each eye postoperatively was determined according to SRK/T formula. When the first-eye refractive error(FERE) exceeded ±0.5 D, the intraocular lens(IOL) power of the second eye was adjusted 50% of the FERE. The second-eye refractive error(SERE) was measured 1 mo after surgery. The FERE exceeded-0.50 D in 12 eyes(-0.675±0.16 D), and the adjusted SERE was-0.322±0.73 D(P<0.05). The FERE exceeded +0.50 D in 8 eyes(1.533±1.14 D),and the adjusted SERE was 0.168±1.36 D(P<0.05). The unadjusted SERE in 60 cases remained-0.38 to 0.42 D when the FERE within ±0.05 D. This prospective study confirmed that the prediction of the second eye could be improved by correcting 50% of FERE when this error exceeded ±0.50 D.
文摘Aim: To evaluate results of cataract surgery in Eye Camp in rural areas. Patients and Method: This study set about the retrospective analysis of cases and operating reports of patients over the age of 10, operated for cataract in Eye Camp and fixed strategy from January, 2010 to December, 2012. Postoperative data were specified and compared. Results: Out of a total of 1145 patients operated, 577 (50.40%) were men compared with 568 (49.60%) women. The general mean age was 62 years, similar in Eye Camp and in fixed strategy. Sixty percent of patients were operated in Eye Camp. After 4 weeks of follow-up, 77% of patients were met again, and 83% among them showed good results (corrected visual acuity = 3/10). This rate of good results was 80.43% in Eye Camp against 87.7% in fixed strategy. We noted 18.25% of complications among which 11.25% were in Eye Camp. The functional outcomes of both strategies get closer to WHO standards. Conclusion: Eye Camp in the Central Region of Togo is an interesting alternative that contributes to the fight against blindness, even if postoperative follow-up is still to be improved.
文摘Introduction: Dry eye disease is currently considered mainly tear film related ocular surface condition. This concept does, however, not respect ocular surface topography. The micro-anatomy of the corneal changes may lead to enhanced demands on the tear film and lead to significant complaints. However, they often remain undetected and hence untreated. It is suggested that the pathophysiology for an entire subgroup of dry eye disease patients is primarily of surface morphological nature. Methods: The tear film break up was observed and used to identify anatomical alterations in eyes of patients with dry eye complaints. The localization and pattern of TFBUT using fluorescein was compared between eye with normal surfaces and surface alterations. Results: Premature tear film rupture was localized at constantly same areas and did match changes on the ocular epitheliopathy in patients with diseases such as microcystic epithliopathy, MFD, and after excimer laser treatment. Disusssion: Whereas in normal surfaces TFBUT does occur within the floating tear film, the anatomical dry eye identifies itself with constant location of tear film break up and a constant spreading pattern. In contrast to the classic, tear film caused dry eye, the anatomical dry eye is accessible to treatment. This should catch our attention and intent to identify it. It is the ease of possible treatment that should make these ocular surface alterations prime target of dry eye disease diagnostic. It is hence suggested to introduce the anatomical dry eye as a subgroup in the large group of dry eye and ocular surface disease.
文摘s from those searches were screened for relevance to our review topics.Publications were included if the subjects included glaucoma patients,and if ocular surface outcomes were described.Non-English papers were excluded.Key Content and Findings:Topical glaucoma medications frequently cause adverse effects on the ocular surface,both through direct action of the medications themselves as well as through toxicity from their associated preservatives.Optimization of the ocular surface may improve medication compliance rates.Traditional surgical treatments for glaucoma,such as trabeculectomy,can exacerbate OSD by disrupting the ocular surface but can also reduce the need for chronic medications.Optimization of ocular surface health is imperative in reducing trabeculectomy complication rates,while also potentially reducing the need for trabeculectomy in patients that are able to achieve intraocular pressure control through improved drop tolerability.The introduction of MIGS represents a promising alternative to existing therapies and has been shown to alleviate the overall medication burden.It would be reasonable to assume that decreasing the medication burden could reduce OSD prevalence and severity.However,more research is needed to directly assess the extent of improvement seen after MIGS.Conclusions:A comprehensive understanding of the importance of OSD in medical and surgical management of glaucoma is essential in optimizing patient care and improving outcomes.