Prevalence and Factors Associated with Dry Eyes Syndrome in Glaucomatous Patients on Anti-Glaucoma Eye Drops Followed up at the Garoua Regional Hospital-Northern Cameroon

Background: Dry eye and glaucoma are two common pathologies in the elderly, and are very often associated. This association suggests a link between them and between their treatments. Our purpose for this study is to determine the prevalence of dry eye in our glaucoma patients treated with eye drops and deduce the factors associated with it. Patients and Methods: We conducted a cross-sectional, analytical study from October 2022 to September 2023 in the ophthalmology department of Garoua Regional Hospital in glaucoma patients aged over 15 years able to answer the Ocular Surface Disease Index (OSDI) questionnaires and treated with antiglaucoma eye drops for more than 3 months. These patients underwent a complete ophthalmological examination and a tear film break-up time test. Results: A total of 73 patients (146 eyes) were examined. The average age of the patients was 47.2 ± 16.5 years, with a male predominance of 54.8%. The prevalence of dry eye syndrome in our patients according to the OSDI score was 56.2% (95% CI) (44.8;67.6). The prevalence of dry eye syndrome on clinical examination of the BUT in the right eye was 83.7% (95% CI) (75.1;92.1) and 79.4% (70.2;88.7) in the left eye. The duration of antiglaucoma treatment was the factor associated with dry eye syndrome (p < 0.05) in glaucoma patients in our setting. Conclusion: Dry Eye Syndrome is common in glaucoma patients on drops in our setting. Treatment duration of more than 1 year seems to be associated with dry eyes.

Insight into small eyes: a practical description from phenotypes presentations to the management

This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthalmos,relative anterior microphthalmos,and nanophthalmos,the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra-and post-operative complications.In this article,we review the criteria by which we recognize and describe pre-,intra-,and post-operative considerations,as well as discuss the ideal intraocular lenses for microphthalmos,given the intricate varieties of small eye phenotypes.

Intraocular pressure before and after capsulorhexis using two viscoelastic substances and two surgical approaches in enucleated porcine eyes

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.

Effectiveness of intravitreal ranibizumab for diabetic macular edema in vitrectomized versus non-vitrectomized eyes:a Meta-analysis

AIM:To evaluate the effectiveness and safety of intravitreal ranibizumab(IVR)for diabetic macular edema(DME)in vitrectomized versus non-vitrectomized eyes.METHODS:The PubMed,EMBASE,Web of Science,Cochrane,EBSCO were comprehensively searched for studies comparing vitrectomized and non-vitrectomized eyes with DME.Clinical outcomes of best-corrected visual acuity(BCVA),central macular thickness(CMT),the mean number of intravitreal injection and adverse events were extracted and analyzed.RESULTS:Six studies involving 641 eyes were included.Final visual gain significantly improved and CMT significantly reduced in vitrectomized eyes at 6mo and 12mo visits(P<0.05).Although the mean reduction in CMT among non-vitrectomized eyes was significantly greater than in vitrectomized eyes at the 6mo[mean difference(MD)=53.57,95%confidence interval(CI):28.03 to 78.72,P<0.0001]and 12mo(MD=49.65,95%CI:19.58 to 79.72,P=0.01),no significant difference was detected in improvement in BCVA at either 6mo(MD=0.05,95%CI:-0.02 to 0.13,P=0.14)or 12mo(MD=0.03,95%CI:-0.04 to 0.09,P=0.43).Injection number of ranibizumab in non-vitrectomized eyes was significantly less than that in vitrectomized eyes during 6-month period(MD=0.60,95%CI:0.16 to 1.04,P=0.008),while there was no statistically significant difference between the two groups during 12mo of follow-up.CONCLUSION:Evidence from current study suggests that IVR was useful for both vitrectomized group and nonvitrectomized group with DME.Although less reduction in macular thickness is found in vitrectomized group,visual improvement between two groups is similar.

Efficacy of Online Learning and Influence on Skin and Eyes Among College Students

To evaluate the efficacy of online learning and explore the impact of long-term use of electronic products on facial skin as well as eyes.A cross-sectional survey was conducted to 180 sophomores in Xi′an Jiaotong University by cluster random sampling from September to October 2021.The questionnaire covering study condition,skin lesion and Ocular Surface Disease Index.χ_(2) test was used to compare the facial skin condition among different groups,and spearman correlation test was used to test the correlation of rank data.During online education,students′learning pressure is reduced,their autonomy is improved,and the learning efficiency is reduced.There were differences in the incidence of facial itching and papules among different groups.Duration of use of electronic products was positively correlated with the facial itching,with an r value of 0.231(P<0.05);the proportion of pigmentation in non-blue light protection groups(12.8%)was higher than that in blue light protection groups(1.7%),the difference was statistically significant(χ_(2)=8.384,P<0.05).The prevalence of dry eye among college students is 66.7%,and the proportion of moderate to severe dry eye is 34.5%.The study autonomy has been improved during online teaching.Long-term use of electronic products and no blue light protection have an impact on facial skin.Students should enhance the knowledge of skin-care and eye-care and develop better habits.

Clinical Efficacy and Safety of Foldable Capsular Vitreous Body Implant Surgery in 22 Cases of Silicone Oil-dependent Eyes

Objective This study aimed to evaluate the clinical efficacy and safety of foldable capsular vitreous body(FCVB)implant surgery in silicone oil-dependent eyes.Methods A total of 22 participants with silicone oil-dependent eyes who received treatment with FCVB implant surgery between January 2019 and June 2020 were included in this retrospective study.The intraocular pressure(IOP),best-corrected visual acuity(BCVA),demographic data,and any recorded complications were evaluated.Results The postoperative IOP(12.73±4.20 mmHg)was significantly improved(P=0.03)compared to the preoperative IOP(10.23±3.69 mmHg)(the main endpoint).There was no significant difference(P=0.33)in the final BCVA preoperation and 3rd month postoperation(the secondary endpoint).The most common postoperative complication was hyphema.Other common postoperative complications included corneal opacity,a shallow anterior chamber,and a low IOP.Conclusion FCVB implant surgery is a safe and effective method for treating silicone oil-dependent eyes;however,attention should be paid to the prevention and timely treatment of complications.

Drosophila Eyes Absent Homologue 2 is up-regulated in lung adenocarcinoma

Objective： Lung cancer has emerged as a leading cause of cancer death in the world. Eyes Absent （EYA） is an important and conserved transcriptional regulator of development. The aim of the present study was to identify the expression of Drosophila Eyes Absent Hemologue 2 （EYA2） in non-small cell lung cancer （NSCLC） and to investigate their correlation with clinical parameters. Methods： Fresh, paired lung samples （n = 59） of NSCLC were obtained by surgical resection at the Department of Thoracic Surgery of the People＇s Liberation Army General Hospital. Expression of EYA2 were examined by Western blot and immunohistochemical analysis in specimens of NSCLC and paired normal lung tissue. Clinical data, pathologic result and Ki67 expression were collected and subsequent correlation with EYA2 expression was analyzed. Results： EYA2 expression was found located in cytoplasm and nucleus, but mostly in cytoplasm. The expression of EYA2 increased in NSCLC by Western blot and immunohistochemistry, which was correlated with histology type, but not correlated with gender, age, pTNM stage, histological differentiation and lymph node metastasis. Compared with normal lung tissue, the expression of EYA2 significantly was up-regulated in lung adenocarcinoma, while no significant difference in lung squamous cell carcinoma. Expression of EYA2 was uncorrelated with expression of Ki67 in NSCLC. Conclusion： Expression of EYA2 was augmented in lung adenocarcinoma. EYA2 is likely participating in tumorigenesis and development of lung adenocarcinoma as transcriptional activator.

How to Protect Eyes

Nowadays, more and more people, especially teenagers have poor eyesight and they have to wear glasses. There are many reasons for this. Some people watch too much TV or play computer games for too long. Some people read books or play mobile phones in dark light. All these behaviors do great harm to eyesight. And some do not know how to protect their eyesight. Here are some ways to protect our eyes. First, we shouldn’t keep our eyes working for a long time. We’d better look at something far away for some time after we study for a long time. Second, we shouldn’t read in a poor light or in the strong the sunlight. Third, doing eye exercises will help us keep good eyesight.

Refractive errors in high myopic eyes after phacovitrectomy for macular hole

AIM: To examine the refractive prediction error in high myopic eyes after phacovitrectomy.METHODS: This retrospective comparative case series included 91 eyes(18 high myopic eyes and 73 non-high myopic eyes) of 91 patients who underwent successful phacovitrectomy(phacoemulsification, intraocular lens implantation, and pars plana vitrectomy). The high myopic eyes were defined as the eye with more than 26.0mm of axial length. The postoperative prediction error of mean error and mean absolute error were evaluated at4 mo postoperatively. Axial length and keratometry measurement were performed preoperatively and 4mo postoperatively using the IOL Master.RESULTS: The refractive outcome after phacovitrectomy showed significantly greater myopic shift in the high myopic eyes [-1.08 ±0.87 diopters(D)] than that in the non-high myopic eyes(-0.43 ±0.63 D, P =0.004). Axial length and keratometric value in the high myopic eyes were significantly increased(P =0.043, 0.037 respectively),whereas those in the non-high myopic group were not significantly increased(P =0.135, 0.347 respectively). The change of the axial length in the myopic eye(0.46±0.28 mm)was greater than that in the non- high myopic eye(0.11 ± 0.34 mm; P 【0.001).CONCLUSION: High myopic eyes showed more myopic shift than non-high myopic eyes after phacovitrectomy.The cause of myopic shift in high myopic eyes seems tobe attributed to actual elongation of the axial length in high myopia.

Measurement of retinal thickness in macular region of high myopic eyes using spectral domain OCT

AIM: To investigate the changes of retinal thickness in macula of high myopic eyes using spectral domain optical coherence tomography(OCT). ·METHODS: Middle-aged and young myopic patients were divided into three groups according to their refractive error/axial length: low and medium myopia group(LMMG),high myopia group(HMG) and super high myopia group(SHMG). Cirrus HD-OCT was used to evaluate total average macular thickness,central subfield thickness,inner/outer macular thickness and macular volume. The differences among experimental groups were analyzed by one-factor analysis of variance. Associations between macular thickness and refractive error/axial length were analyzed by Pearson correlation analysis. ·RESULTS: There was no significant difference in age among the three groups(P =0.2789). The mean refraction error in the LMMG,HMG,and SHMG groups was-2.49 ± 1.38D,-8.53 ±1.95D and-13.88 ±1.76D,respectively(P 【 0.001). The central subfield thickness of three groups was 244.56 ±12.19μm,254.33 ±11.61μm and 261.75 ± 11.83μm,respectively,and there were statistically significance between random two groups. The total average macular thickness,inner/outer macular thickness,and macular volume decreased with increased myopia/axial length. Average foveal thickness had negative correlations with refractive error(P 【0.001),and positive correlations with axial length. The inferior and temporal inner macular thickness,all the quadrants of outer ring,total average macular thickness and macular volume featured positive correlations with refractive error,and negative correlations with axial length. Average foveal thickness,superior and temporal innermacular thicknesses,and temporal outer macular thickness was lower in females compared to males. ·CONCLUSION: With an increase in myopia degree/axial length,the average foveal thickness increased and the inner/outer macular thickness decreased. Females featured thicker average foveal thickness,and thinner macular thickness compared to males.

Vitrectomy combined with silicone oil tamponade in the treatment of severely traumatized eyes with the visual acuity of no light perception

AIM: To evaluate the efficacy of surgical treatment of vitrectomy combined with silicone oil tamponade in the treatment of severely traumatized eyes with the visual acuity of no light perception (NLP).METHODS: This was a retrospective uncontrolled interventional case-series of 19 patients of severely traumatized eyes with NLP who underwent vitrectomy surgery at the Affiliated Hospital of Medical College, Qingdao University (Qingdao, China) during a 3-year period. We recorded perioperative factors with the potential to influence functional outcome including duration from the injury to intervention; causes for ocular trauma; open globe or closed globe injury; grade of vitreous hemorrhage; grade of endophthalmitis; grade of retinal detachment; size and location of intraocular foreign body (IOFB); extent and position of retinal defect; grade of proliferative vitreoretinopathy (PVR); type of surgery; perioperative complications and tamponade agent. The follow-up time was from 3 to 18 months, and the mean time was 12 months.RESULTS: After a mean follow-up period of 12 months (3-18 months) 10.53% (2/19) of eyes had visual acuity of between 20/60 and 20/400, 52.63% (10/19) had visual acuity less than 20/400 but more than NLP, and 36.84% (7/19) remained NLP. Visual acuity was improved from NLP to light perception (LP) or better in 63.16% (12/19) of eyes and the rate of complete retinal reattachment was 73.68% (14/19). Good visual acuity all resulted from those patients of blunt trauma with intact eyewall (closed globe injury). The perioperative factors of poor visual acuity prognosis included delayed intervention; open globe injury; endophthalmitis; severe retinal detachment; large IOFB; macular defect; a wide range of retinal defects andsevere PVR.CONCLUSION: The main reasons of NLP after ocular trauma are severe vitreous hemorrhage opacity; refractive media opacity; retinal detachment; retinal and uveal damages and defects, especially defects of the macula; PVR and endophthalmitis. NLP after ocular trauma in some cases does not mean permanent vision loss. Early intervention of vitrectomy combined with silicone oil tamponade and achieving retinal reattachment of the remaining retina, may make the severely traumatized eyes regain the VA of LP or better.

A Novel System for Moving Object Detection Using Bionic Compound Eyes

Conventional moving target detection focuses on algorithms to improve detection efficiency. These algorithms pay less attention to the image acquisition means, and usually solve specific problems. This often results in poor flexibility and reus- ability. Insect compound eyes offer unique advantages for moving target detection and these advantages have attracted the attention of many researchers in recent years. In this paper we proposed a new system for moving target detection. We used the detection mechanism of insect compound eyes for the simulation of the characteristics of structure, control, and function. We discussed the design scheme of the system, the development of the bionic control circuit, and introduced the proposed mathe- matical model of bionic cqmpound eyes for data acquisition and object detection. After this the integrated system was described and discussed. Our paper presents a novel approach for moving target detection. This approach effectively tackles some of the well-known problems in the field of view, resolution, and real-time processing problems in moving target detection.

Corneal endothelial cell density and morphology in low and moderate myopic Chinese eyes

AIM:To describe and compare the corneal endothelial cell density and morphology in young,low and moderate myopic Chinese adults in Malaysian Chinese population.·METHODS:Non-contact specular microscopy(Topcon SP3000P,Tokyo,Japan) was performed in low(n =78;21.22±1.51 years) and moderate(n =78;21.82±1.40 years)myopic subjects.The mean of three consecutive measurements of endothelial cell density(MCD),coefficient of variation(CV) in the cell size,and hexagonal appearance of the cell were obtained.·RESULTS:In low myopic eyes the MCD was 3 063.0±176.2/mm2,the mean CV was 33.4 ±4.0% and the mean hexagonal appearance of the cell was 57.9 ±2.7%.In moderate myopic eyes the MCD was 2961.6 ±159.0/mm2,the mean CV was 33.9 ±3.6% and mean hexagonal appearance of the cell was 56.2 ±4.7%.There were statistically significant differences in MCD(P 【0.000) and hexagonal appearance of the cell(P 【0.005) between low and moderate myopic eyes.·CONCLUSION:The corneal endothelial cell layer in more myopic eyes tends to have less MCD and cell hexagonality compared to lower myopic eyes.Nevertheless,there is no significant difference in CV between low and moderate myopic eyes.

Characteristics of Pattern Visual Evoked Potential in Two Eyes with Varying Visual Acuity in One Eye and Forensic Application

In this study, we aimed to study the pattern visual evoked potentials （P-VEPs） in two eyes with varying visual acuity in one eye and to provide an objective estimation of visual acuity by comparing P-VEPs in one and two eyes. Thirty subjects were chosen, who had one eye with an acuity of 5.0, 4.85, 4.6, 4.0, or scieropia and obstructed vision and the other eye with an acuity of 5.0, respectively. P-VEPs were detected under the large grating stimuli at 3x4 spatial frequency, moderate grating stimuli （12× 16 spatial frequency） and small grating stimuli （48×64 spatial frequency）. Under large grating stimuli, there was no significant difference in P100 peak latency between the groups, nor was there a significant difference between the amplitude of two eyes and the amplitude of one normal-vision eye. Under moderate and small grating stimuli, there was a significant difference in P100 peak latency between the group with both eyes having an acuity of 5.0 and the group with visual acuity below 4.0 in one eye. There was a significant difference in P100 amplitude between the group with visual acuity of 5.0 in both eyes and the group with one normal-vision eye. There was no significant difference in the amplitude of two eyes and the amplitude of one normal-vision eye between any other two groups. In forensic identification, characteristics and variability of P-VEPs in one and two eyes can be used to identify malingering or decline in visual acuity.

Fabrication of Waterproof Artificial Compound Eyes with Variable Field of View Based on the Bioinspiration from Natural Hierarchical Micro–Nanostructures

Planar and curved microlens arrays(MLAs)are the key components of miniaturized microoptical systems.In order to meet the requirements for advanced and multipurpose applications in microoptical field,a simple manufacturing method is urgently required for fabricating MLAs with unique properties,such as waterproofness and variable field-of-view(FOV)imaging.Such properties are beneficial for the production of advanced artificial compound eyes for the significant applications in complex microcavity environments with high humidity,for instance,miniature medical endoscopy.However,the simple and effective fabrication of advanced artificial compound eyes still presents significant challenges.In this paper,bioinspired by the natural superhydrophobic surface of lotus leaf,we propose a novel method for the fabrication of waterproof artificial compound eyes.Electrohydrodynamic jet printing was used to fabricate hierarchical MLAs and nanolens arrays(NLAs)on polydimethylsiloxane film.The flexible film of MLAs hybridized with NLAs exhibited excellent superhydrophobic property with a water contact angle of 158°.The MLAs film was deformed using a microfluidics chip to create artificial compound eyes with variable FOV,which ranged from 0°to 160°.

DISTANCE MEASURING MODELING AND ERROR ANALYSIS OF DUALCCD VISION SYSTEM SIMULATING HUMAN EYES AND NECK

A dual-CCD simulating human eyes and neck (DSHEN) vision system is putforward. Its structure and principle are introduced. The DSREN vision system can perform somemovements simulating human eyes and neck by means of four rotating joints, and realize preciseobject recognizing and distance measuring in all orientations. The mathematic model of the DSHENvision system is built, and its movement equation is solved. The coordinate error and measureprecision affected by the movement parameters are analyzed by means of intersection measuringmethod. So a theoretic foundation for further research on automatic object recognizing and precisetarget tracking is provided.

Femtosecond laser fabrication of 3D templates for mass production of artificial compound eyes

Compound eyes are unique optical imaging systems that consist of numerous separate light-sensitive units(ommatidia).Attempts have been made to produce artificial compound eyes via advanced 3 D nanotechnologies.Among them,femtosecond laser direct writing(FsLDW)technology has emerged as an effective strategy due to its distinct advantages in 3 D designable and high precision fabrication capability.However,the point-by-point scanning process results in a very low fabrication efficiency,limiting the practical applications of the FsLDW technology.To solve this problem,we propose a high-efficiency method for the mass production of 3 D artificial compound eyes using a photopolymer template fabricated by FsLDW.The resultant 3 D SU-8 compound eye templates could be used to replicate polydimethylsiloxane(PDMS)compound eyes many times(over 50 times)with a highly improved efficiency(nearly 20 times higher than the efficiency of direct fabrication using the point-by-point FsLDW).The PDMS replicas showed good focusing and imaging performances.We anticipate that this method may serve as an enabler for the mass production of 3 D artificial compound eyes and promote their practical applications in the near future.

Theoretical and Experimental Research on Error Analysis and Optimization of Tool Path in Fabricating Aspheric Compound Eyes by Precision Micro Milling

Structure design and fabricating methods of three-dimensional （3D） artificial spherical compound eyes have been researched by many scholars. Micro-nano optical manufacturing is mostly used to process 3D artificial compound eyes. However, spherical optical compound eyes are less at optical performance than the eyes of insects, and it is difficult to further improve the imaging quality of compound eyes by means of micro-nano optical manufacturing. In this research, nonhomogeneous aspheric compound eyes （ACEs） are designed and fabricated. The nonhomogeneous aspheric structure is applied to calibrate the spherical aberration. Micro milling with advantages in processing three-dimensional micro structures is adopted to manufacture ACEs. In order to obtain ACEs with high imaging quality, the tool paths are optimized by analyzing the influence factors consisting of interpolation allowable error, scallop height and tool path pattern. In the experiments, two kinds of ACEs are manufactured by micro-milling with different too path patterns and cutting parameter on the miniature precision five-axis milling machine tool. The experimental results indicate that the ACEs of high surface quality can be achieved by circularly milling small micro-lens individually with changeable cutting depth. A prototype of the aspheric compound eye （ACE） with surface roughness （Ra） below 0.12 p.m is obtained with good imaging performance. This research ameliorates the imaging quality of 3D artificial compound eyes, and the proposed method of micro-milling can improve surface processing quality of compound eyes.

Bleb needling outcomes for failed trabeculectomy blebs in Asian eyes: a 2-year follow up

·AIM: To describe the outcomes of bleb needling in primary glaucoma in an Asian tertiary eye centre over a2 y period. To compare the success rates between primary angle-closure glaucoma(PACG) and primary open angle glaucoma(POAG). Lastly, to identify factors associated with success of bleb needling.·METHODS: This was a retrospective review of 227 patients who underwent bleb needling between June2009 and June 2011 in Singapore National Eye Centre.The 5-fluorouracil(5-FU) augmented bleb needling was performed either at the slit lamp or in the operating theatre. Repeat bleb needlings were performed as necessary. Complete success was defined as maintenance of intraocular pressure(IOP) ≥6 mm Hg and ≤21 mm Hg, in the absence of further surgery or use of antiglaucoma medication. Qualified success met the above criteria with or without use of antiglaucoma medications.· RESULTS: One hundred and seventy-five eyes completed the two-year follow up. Sixty-nine percent of participants had POAG and 31% had PACG. The mean interval between filtering surgery and bleb needling was299.9 ±616.4d for POAG and 167.1 ±272.2d for PACG.Mean needling attempts were 1.9±1.4 and 2±1.6 for POAG and PACG respectively. In general, there was a statistically significant reduction of IOP ranging from21.9% to 26.8% from month 1 through to month 24. The complete success rates at month 6 were 70.0% for POAG and 65.7% for PACG. At month 12, this decreased to62.2% for POAG and PACG and at month 24, 57.9% for POAG and 63.0% for PACG respectively. The qualified success rates at month 6 for POAG and PACG were23.8% and 29.9% respectively, 32.2% and 29.2% at month12, and 34.7% and 29.6% at month 24. The success ratesbetween POAG and PACG were not significantly different(P 】0.05 for complete and qualified success at months 6,12 and 24). An increased number of needlings and higher pre-needling IOP were associated with failure.·CONCLUSION: The 5-FU augmented bleb needling within one year of trabeculectomy in Asian eyes can provide clinically significant IOP lowering of more than20% for 2y. POAG and PACG had similar complete success rates(58% and 63% respectively). Factors associated with greater risk of procedure failure included increased number of needlings and higher pre-needling IOP. Asian eyes have a greater propensity for scarring but bleb needling, if performed in a timely manner can rescue bleb function.

Safety and effectiveness of an iris hook assisted phacoemulsification in vitrectomized eyes

AIM:To introduce a simple iris hook assisted phacoemulsification(PE)procedure and evaluate the safety and efficacy of it in completely vitrectomized eyes.METHODS:A single centre study which included 65 previously completely vitrectomized eyes of 62 patients who underwent cataract surgery.Patients were randomly divided into 3 groups.Patients received PE,and intraocular lens(IOL)implantation with the assistance of iris hook(SynergetiesTM)as group A(25 eyes);patients who received PE assisted with a 25 G pars plana irrigation as group B(20 eyes),and patients who received PE performed without the help of any instrument as group C(20 eyes).Main outcome measures were surgery duration,Ultrasound(U/S)total time,endothelial cell density(ECD),cumulative dissipated energy(CDE)and complications of the procedures.RESULTS:With the help of iris hook,the patients in group A had the lowest ECD loss rate(0.07±0.03,0.09±0.03,and 0.10±0.03,P<0.05),shortest CDE(12.2±4.1,15.8±6.0,and 16.0±6.0,P<0.05)and U/S total time(36.6±13.0 s,46.3±16.4 s,and 47.6±16.1 s,P<0.05),and minimal incidence of complications.The longest surgery duration was in group B(19.4±1.6 min)and maximum complications rate in group C(20%miosis,10%posterior capsular tears,5%zonular dialysis,5%cystoid macular edema).While best-corrected visual acuity(BCVA),intraocular pressure(IOP)and ECD did not show a significant difference among the three groups.CONCLUSION:Without prolonged surgery duration,the iris hook assistant method can minimize heat generation during surgery and incidence of complications,which transfer the challenged PE in vitrectomized eyes into a regular surgery.It does not need any change in the hydrodynamic parameters and in the bag PE technique,easy to operate even for junior surgeons.