Insights on the possibility of SARS-CoV-2 transmission through the eyes

A novel coronavirus, named severe acute respiratory syndrome coronavirus 2(SARS-Co V-2 or 2019-nCOV), causing coronavirus disease 2019(COVID-19), has rapidly spread to most countries and regions worldwide since it broke out at the end of 2019. Epidemic of the virus produces a tremendous pressure on the global health systems. With progressive insight into SARS-Co V-2, the role of eye tissue has attracted wide attention in the spread of COVID-19. Whether SARS-Co V-2 can enter the human body through eyes and cause infection? The fact that unprotected exposure of the eyes to 2019-n Co V might have allowed the virus to infect the body implies that 2019-n COV can invade eye tissue and set foot in organism. Facing the severe challenge of preventing spread of the COVID-19, combined with the high-risk environment of ophthalmology, it is crucial to investigate ocular tropism of coronavirus. This paper explores the possibility of coronavirus transmission through the eye from aspects of probable mechanisms, clinical cases, detection of coronavirus;and puts forward precautions for ophthalmologists and nurses. Consequently, this review reveals our understanding of ocular tropism of coronavirus and contributes to determining risk of ocular transmission, raising awareness of necessary eye protection among medical workers and reducing further prevalence of SARS-Co V-2.

Visual function and higher order aberration after implantation of aspheric and spherical multifocal intraocular lenses:a meta-analysis

AIMTo assess the visual outcomes of aspheric multifocal intraocular lenses (IOLs) compared with spherical multifocal IOL after cataract surgery.

miR-211 regulates the antioxidant function of lens epithelial cells affected by age-related cataracts

AIM： To investigate the effects and mechanism of miR-211 in mediating the antioxidant function of lens epithelial cells affected by age-related cataracts. METHODS： Real-time quantitative polymerase chain reaction （RT-qPCR） was used to detect miR-211 expression in the anterior lens capsules of healthy people, the anterior lens capsules of patients with age-related cataracts, and human epithelial cell line （SRA01/04） cells exposed to oxidative stress. A 2＇, 7＇-dichloro-fluorescein diacetate （DCFH-DA） probe was used to measure the levels of endogenous reactive oxygen species （ROS） in human lens epithelial cells （hLECs） exposed to 400 pmol/L H2O2 for lh. SRA01/04 cells were transfected with either miR-211 mimics, mimic controls, miR-211 inhibitors or inhibitor controls. After 72h, these cells were exposed to 400 IJmollL H2O2 for lh, then p53 and Bax mRNA expression were measured using RT-qPCR. p53 and Bax protein expression were also measured by Western blotting analysis. Finally, cell viability was assessed using an MTS assay. RESULTS： Compared to the control group, expression of miR-211 in the anterior lens capsules of age-related cataract patients and in SRA01/04 cells exposed to oxidative stress was significantly increased （P〈0.001）. Levels of endogenous ROS were significantly elevated in hLECs exposed to oxidative stress （P〈0.001）. Compared to the mimic control group, the hLECs in the miR-211 mimic group expressed significantly higher levels of p53 and Bax mRNA and protein while cell viability was significantly reduced （P〈0.001）. Conversely, p53 and Bax mRNA and protein expression were significantly reduced in the miR-211 inhibitor group as compared to the control group, while the cells in this group had much higher levels of call viability （P〈0.001）. CONCLUSION： miR-211 is upregulatsd in the anterior lens capsules of age-related cataract patients, miR-211 decreased the antioxidative stress capacity of lens epithelial cells by upregulating p53 and Bax, while inhibiting cell proliferation and repair. This finding suggests that miR-211 may play a key role in the development of age-related cataracts.

Role of Smad4 from ocular surface ectoderm in retinal vasculature development

●AIM:To investigate how signals from lens regulate retinal vascular development and neovascularization.●METHODS:Le-Cre transgenic mouse line was employed to inactivate Smad4 in the surface ectoderm selectively.Standard histological and whole-mount retina staining were employed to reveal morphological changes of retinal vasculature in Smad4 defective eye.cDNA microarray and subsequent analyses were conducted to investigate the molecular mechanism underlying the vascular phenotype.Quantitative polymerase chain reaction(qPCR)was carried out to verify the microarrays results.●RESULTS:We found that inactivation of Smad4 specifically on surface ectoderm leads to a variety of retinal vasculature anomalies.Microarray analyses and qPCR revealed that Sema3 c,Sema3 e,Nrp1,Tie1,Sox7,Sox17,and Sox18 are significantly affected in the knockout retinas at different developmental stages,suggesting that ocular surface ectoderm-derived Smad4 can signal to the retina and regulates various angiogenic signaling in the retina.●CONCLUSION:Our data suggest that the cross-talk between ocular surface ectoderm and retina is important for retinal vasculature development,and Smad4 regulates various signaling associated with sprouting angiogenesis,vascular remodeling and maturation in the retina of mice.

Comparison of measurements of anterior chamber angle via anterior segment optical coherence tomography and ultrasound biomicroscopy

BACKGROUND Glaucoma is an irreversible optic neuropathy with the loss of visual field and decrease of vision.The variable clinical manifestations may result in differential diagnostic difficulties.The early screening and diagnosis of glaucoma are currently experiencing a demand for anterior segment analysis tools that can gather more information with one short measurement.Therefore,we analyzed the agreement,difference,and correlation of chamber angle parameters such as angel opening distance at 500μm(AOD500)and trabeculo-iris space area at 500μm^2(TISA500)measured by anterior segment optical coherence tomography(ASOCT)and ultrasound biomicroscopy(UBM).AIM To compare the differences,correlation,and agreement in measuring AOD500 and TISA500 by AS-OCT and UBM.METHODS Both AS-OCT and UBM were performed to measure AOD500 and TISA500 in 45 subjects(72 eyes).All subjects without glaucoma were collected from October 2015 to August 2016 at the Ophthalmology Department of the Fourth Affiliated Hospital of China Medical University.Data of the two groups(AOD500 and TISA500)were compared by nonparametric tests.Pearson correlative analysis and Bland-Altman analysis were used to compare the correlation and agreement.RESULTS There were no significant differences between AS-OCT and UBM in measuring AOD500(P1=0.110,P2=0.633,P3=0.078,and P4=0.474)and TISA500(P1=0.584,P2=0.889,P3=0.297,and P4=0.550)of the four quadrants of the anterior chamber angle.There was a high correlation in measuring AOD500(r1=0.562,r2=0.671,r3=0.635,and r4=0.720;P<0.001)and TISA500(r1=0.584,r2=0.889,r3=0.297,and r4=0.550;P<0.001).There was a good agreement in measuring AOD500 and TISA500 by the two modalities.CONCLUSION There is a high correlation and agreement between AOD500 and TISA500 measurements by AS-OCT and UBM.They are interchangeable under some circumstances.AS-OCT proves to be a better early screening tool for glaucoma.

Bibliometric analysis and mapping knowledge domain of pterygium:2000-2019

AIM:To track the knowledge structure,topics in focus,and trends in emerging research in pterygium in the past 20 y.METHODS:Base on the Web of Science Core Collection(Wo SCC),studies related to pterygium in the past 20 y from 2000-2019 have been included.With the help of VOSviewer software,a knowledge map was constructed and the distribution of countries,institutions,journals,and authors in the field of pterygium noted.Meanwhile,using cocitation analysis of references and co-occurrence analysis of keywords,we identified basis and hotspots,thereby obtaining an overview of this field.RESULTS:The search retrieved 1516 publications from Wo SCC on pterygium published between 2000 and 2019.In the past two decades,the annual number of publications is on the rise and fluctuated a little.Most productive institutions are from Singapore but the most prolific and active country is the United States.Journal Cornea published the most articles and Coroneo MT contributed the most publications on pterygium.From cooccurrence analysis,the keywords formed 3 clusters:1)surgical therapeutic techniques and adjuvant of pterygium,2)occurrence process and pathogenesis of pterygium,and 3)epidemiology,and etiology of pterygium formation.These three clusters were consistent with the clustering in co-citation analysis,in which Cluster 1 contained the most references(74 publications,47.74%),Cluster 2 contained 53 publications,accounting for 34.19%,and Cluster 3 focused on epidemiology with 18.06%of total 155 cocitation publications.CONCLUSION:This study demonstrates that the research of pterygium is gradually attracting the attention of scholars and researchers.The interaction between authors,institutions,and countries is lack of.Even though,the research hotspot,distribution,and research status in pterygium in this study could provide valuable information for scholars and researchers.

Acute lens opacity induced by different kinds of anesthetic drugs in mice

AIM: To study whether specific anesthetic drugs or tear layer evaporation was primarily responsible for the acute cataract and what the change of lens structure is in anesthetized mice.METHODS: Five groups were set up in the experiment: Group A(topicamide and phenylephrine mixed eye drop+ chloral hydrate), Group B(tropicamide and phenylephrine mixed eye drop+sevoflurane), Group C(tropicamide and phenylephrine mixed eye drop), Group D(topicamide and phenylephrine mixed eye drop+chloral hydrate, carbomer eye drop in the right eyes), and Group E(tropicamide and phenylephrine mixed eye drop+sevoflurane, carbomer eye drop in the right eyes). A simple classification system was used to assess the severity of lens opacity. And a numerical value from 0 to 3 to each grade was assigned for the cataract index calculation and data analysis. The gross appearance and time course of development of lens opacity were assessed. Hematoxylin and eosin staining was used to observe the lens structure changes in the reversible cataract.RESULTS: Tropicamide did not induce lens opacification in mice. Lens opacity caused by inhaled sevoflurane was similar to injected cholral hydrate. Both inhaled-anestheticinduced lens opacity and injected-anesthetic-induced lens opacity could be prevented by carbomer eye drop. In the severe opacity lens, a wide range of lens fiber cell structure had disordered. The fiber cells became uneven thickness.CONCLUSION: The acute reversible lens opacity can unilaterally develop or be induced by a local cause. The structure of lens fiber cells changed in the lens opacity which may influence the permanent connection of the lens fiber cells. This study was not only of practical significance to help maintain lens transparency for eye research, but also of the deeper consideration about the reversible lens opacification phenomenon.

Comparison of 25 MHz and 50 MHz ultrasound biomicroscopy for imaging of the lens and its related diseases

AIM： To compare the results of 25 MHz and 50 MHz ultrasound biomicroscopy（UBM） regarding the image characteristics of the lens and its related diseases and to discuss the application value of 25 MHz UBM in ophthalmology. METHODS： A total of 302 patients（455 eyes） were included in this study from November 2014 to May 2015. Patient ages ranged from 5 to 89 y（mean±SD： 61.0±17.7 y）. Different cross-sectional images of the lens were collected to compare and analyze the image characteristics and anterior segment parameters using 25 MHz and 50 MHz UBM in axial and longitudinal scanning modes, respectively. SPSS 19.0 for Windows, paired t-tests and B＆A plot analysis were used for data analysis, and a value of P〈0.05 was considered statistically significant. RESULTS： The 25 MHz UBM images displayed the lens shape more clearly than 50 MHz UBM images. Particularly for cataracts, the whole opacity of the lens was shown by 25 MHz UBM, but 50 MHz UBM only showed part of the lens. The means of the anterior segment parameters obtained using 25 MHz and 50 MHz UBM were as follows： central corneal thickness： 0.55±0.03 and 0.51±0.04 mm, respectively; central anterior chamber depth： 2.48±0.54 and 2.56±0.56 mm, respectively; and central lens thickness： 4.26±0.62 and 4.15±0.56 mm, respectively. A statistically significant difference was found between the results obtained with 25 MHz UBM and those obtained with 50 MHz UBM. The two devices had a good agreement in measuring the anterior segment parameters. CONCLUSION： The 25 MHz UBM had an obvious advantage in showing the lens shape. It can provide reliable imaging of the lens and its related diseases and has a high application value for ophthalmology.

Analysis on the psychological characteristics of patients with acute iridocyclitis

【正】Dear Sir,I am Dr.Wei Sun,from the Department of Ophthalmology,the Fourth Affiliated Hospital of China Medical University,Eye Hospital of China Medical University,shenyang,Liaoning Province,China.I write to present our study on the psychological characteristics of patients with acute iridocyclitis.Studies showed stimulation from patient’s external environment could influence their psychological state,persisting neural endocrine disorders that might lead to a series of physiological and psychological changes in the human body[1-6].It was confirmed many ocular diseases were

Endoscopic transnasal optic canal decompression for pediatric traumatic optic neuropathy with no light perception

Dear Editor,We reported the results of endoscopic transnasal optic canal decompression(ETOCD)procedure in 3 pediatric cases(9 to 12y,mean age 10.3y)of traumatic optic neuropathy(TON)with no light perception suffering from road traffic accident.TON is a rare but serious complication secondary to ocular or head trauma,resulting in partial or complete visual loss.In China,the incidence of road traffic accident induced TON is on the rise.The rate of incidence has been reported about 0.5% to 5% in closed head trauma cases[1].

SUMOylation and deacetylation affect NF-κB p65 activity induced by high glucose in human lens epithelial cells

AIM: To explore the effects of IκBα SUMOylation and NF-κB p65 deacetylation on NF-κB p65 activity induced by high glucose in cultured human lens epithelial cells(HLECs).METHODS: HLECs(SRA01/04) were cultured with 5.5, 25, and 50 mmol/L glucose media for 24 h, and with 50 mmol/L glucose media for 0, 12, and 24 h respectively. SUMO1 and SIRT1 expressions were detected by reverse transcriptionpolymerase chain reaction(RT-PCR) and Western blot(WB). IκBα and NF-κB p65 expressions were detected by WB. With NAC, DTT, MG132 or Resveratrol(RSV) treatment, SUMO1 and SIRT1 expressions were detected by WB. Protein expression localizations were examined by immunofluorescence and co-immunofluorescence. The effects of SUMO1 or SIRT1 overexpression, as well as MG132 and RSV, on the nuclear expression and activity of IκBα and NF-κB p65 were analyzed by immunoblot and dual luciferase reporter gene assay.RESULTS: SUMO1 and SIRT1 expressions were influenced by high glucose in mRNA and protein levels, which could be blocked by NAC or DTT. SUMO1 was down-regulated by using MG132, and SIRT1 was up-regulated under RSV treatment. IκBα nuclear expression was attenuated and NF-κB p65 was opposite under high glucose, while IκBα and NF-κB p65 location was transferred to the nucleus. SUMO1 or SIRT1 overexpression and MG132 or RSV treatment affected the nuclear expression and activity of IκBα and NF-κB p65 under high glucose condition.CONCLUSION: IκBα SUMOylation and NF-κB p65 deacetylation affect NF-κB p65 activity in cultured HLECs under high glucose, and presumably play a significant role in controlling diabetic cataract.

Trends in research related to high myopia from 2010 to 2019:a bibliometric and knowledge mapping analysis

AIM:To evaluate the global trends in and explore hotspots of high myopia(HM)research.METHODS:This bibliometric analysis was used to reveal the publication trends in HM research field based on the Web of Science Core Collection(WoSCC).VOSviewer version 1.6.13 software was used to analyze the data and construct a knowledge map including the yearly publication number,journals,countries,international collaborations,authors,research hotspots,and intellectual base in HM.RESULTS:The search engine found 3544 peer-reviewed publications on HM between 2010 and 2019,and the yearly research output substantially elevated over the past decade.China is the top publishing country,and Sun Yatsen University was the most active academic institution.Jonas JB is the top publishing scientist,and Investigative Ophthalmology and Visual Science(IOVS)was the most productive journal.The highest cited references mainly focused on epidemiology and management.The keywords formed 6 clusters:1)refractive surgery;2)etiology and clinical characteristics;3)the mechanism of eye growth;4)management for myopic maculopathy;5)vitrectomy surgical treatment;6)myopia-associated glaucoma-like optic neuropathy.CONCLUSION:The evaluation of development trends based on the data extracted from WoSCC can provide valuable information and guidance for ophthalmologists and public health researchers to improve management procedures in HM field.

Human lens epithelial cell apoptosis and epithelial to mesenchymal transition in femtosecond laser-assisted cataract surgery

AIM： To evaluate human lens epithelium cell apoptosis and epithelial to mesenchymal transition （EMT） induced by femtosecond laser in femtosecond laser assisted cataract surgery （FLACS）. METHODS： Sixty cataract patients with N2 to N3 stage according to the LOCS III were enrolled in this study and divided into three groups randomly： FLACSl group （cataract surgery by FLACS with LenSx）, FLACS2 group （cataract surgery by FLACS with LensAR） and manual group （cataract surgery by phacoemulsification）. Patients in two FLACS groups performed anterior capsulotomy by LenSx or LensAR laser system. Patients in the manual group were performed continuous curvilinear capsulorrhexis （CCC） manually. The anterior capsules were fixed right after moved out of eye. Hematoxylin-eosine staining, immunofluorescence staining and real-time PCR were performed in order to observe human lens epithelium cells changes after cataract surgery. RESULTS： The capsule cutting edge was shown irregularity and roughness in two FLACS groups and smooth edge in manual capsulotomy by pathologic staining. Irregularities of the cell configuration with partly swollen and destroyed nuclei were observed in two FLACS groups. Femtosecond laser could induce a significantly higher cell apoptosis in human lens epithelium cell than manually performed CCC （P〈0.05）. Lens epithelium cells apoptosis were correlated with femtosecond laser duration according to Pearson correlation analysis. Decreased N-cadherin expression, alpha-SMA and FSP-1 level in two FLACS groups showed the inhibition of cell EMT. CONCLUSION： Femtosecond laser may affect the apoptosis and EMT of lens epithelium cells which are under the peeled central lens capsule.

Anterior segment dysgenesis correlation with epithelial-mesenchymal transition in Smad4 knockout mice

AIM： To explore the molecular mechanisms in lens development and the pathogenesis of Peters anomaly in Smad4 defective mice. METHODS： Le-Cre transgenic mouse line was employed to inactivate Smad4 in the surface ectoderm selectively. Pathological techniques were used to reveal the morphological changes of the anterior segment in Smad4 defective eye. Immunohistochemical staining was employed to observe the expression of E-cadherin, N- cadherin and α-SMA in anterior segment of Smad4 defective mice and control mice at embryonic （E） day 16.5. Real-time quantitative polymerase chain reaction （qPCR） was performed to detect the expression of Snail, Zebl, Zeb2 and Twist2 in lens of Smad4 defective mice and control mice at E16.5. RESULTS： Conditional deletion of Smad4 on eye surface ectoderm resulted in corneal dysplasia, iridocorneal angle closure, corneolenticular adhesions and cataract resembling Peters anomaly. Loss of Smad4 function inhibited E-cadherin expression in the lens epithelium cells and corneal epithelium cells in Smad4 defective eye. Expression of N-cadherin was upregulated in corneal epithelium and corneal stroma. Both E-cadherin and N-cadherin were down-regulated at the future trabecular meshwork region in mutant eye. The qPCR results showed that the expression of Twist2 was increased significantly in the mutant lens （P〈0.01）. CONCLUSION： Smad4 is essential to eye development and likely a candidate pathogenic gene to Peters anomaly by regulating epithelial-mesenchymal transition. Twist2 can be regulated by Smad4 and plays an essential role in lens development.

Sustained-release genistein from nanostructured lipid carrier suppresses human lens epithelial cell growth

AIM： To design and investigate the efficacy of a modified nanostructured lipid carrier loaded with genistein（Gen-NLC） to inhibit human lens epithelial cells（HLECs） proliferation.·METHODS： Gen-NLC was made by melt emulsification method. The morphology, particle size（PS）, zeta potentials（ZP）, encapsulation efficiency（EE） and in vitro release were characterized. The inhibition effect of nanostructured lipid carrier（NLC）, genistein（Gen） and Gen-NLC on HLECs proliferation was evaluated by cell counting kit-8（CCK-8） assay, gene and protein expression of the proliferation marker Ki67 were evaluated with real-time quantitative polymerase chain reaction（RT-q PCR） and immunofluorescence analyses.·RESULTS： The mean PS of Gen-NLC was 80.12±1.55 nm with a mean polydispersity index of 0.11±0.02. The mean ZP was-7.14 ±0.38 m V and the EE of Gen in the nanoparticles was 92.3% ±0.73%. Transmission electron microscopy showed that Gen-NLC displayed spherical-shaped particles covered by an outer-layer structure. In vitro release experiments demonstrated a prolonged drug release for 72 h. The CCK-8 assay results showed the NLC had no inhibitory effect on HLECs and Gen-NLC displayed a much more prominent inhibitory effect on cellular growth compared to Gen of the same concentration. The m RNA and protein expression of Ki67 in LECs decreased significantly in Gen-NLC group.·CONCLUSION： Sustained drug release by Gen-NLCs may impede HLEC growth.

miR-211 promotes lens epithelial cells apoptosis by targeting silent mating-type information regulation 2 homolog 1 in age-related cataracts

AIM： To detect the expression of miR-211 in age-related cataract tissue, explore the effects of miR-211 on lens epithelial cell proliferation and apoptosis, and identify its target gene.METHODS： This study used real-time quantitative polymerase chain reaction（RT-q PCR） to measure the expression of miR-211 and its predicted target gene [silent matingtype information regulation 2 homolog 1（SIRT1）] in 46 anterior lens capsules collected from age-related cataract patients. Human lens epithelial cell line（SRA01/04） cells were transfected with either miR-211 mimics, mimic controls, miR-211 inhibitors or inhibitor controls, 72 h after transfection, miR NA and protein expression of SIRT1 were measured using RT-qP CR and Western blotting; then cells were exposed to 200 μmol/L H2O2 for 1h, whereupon cell viability was measured by MTS assay, caspase-3 assay was performed. Dual luciferase reporter assay was performed to verify the relationship between miR-211 of SIRT1.RESULTS： Compared to the control group, expression of miR-211 was significantly increased（P〈0.001）, the miR NA and protein expression of SIRT1 were significantly decreased（P〈0.001） in the anterior lens capsules of patients with age-related cataracts. Relative to the control group, SIRT1 miR NA and protein levels in the miR-211 mimic group were significantly reduced, cell proliferation activity significantly decreased, and caspase-3 activity was significantly increased（P〈0.001）. In the miR-211 inhibitor group, SIRT1 miRNA and protein expression were significantly increased, cell proliferation activity significantly increased, and caspase-3 activity was significantly decreased（P〈0.001）. A dual luciferase reporter assay confirmed that SIRT1 is a direct target of miR-211.CONCLUSION： miR-211 is highly expressed in the anterior lens capsules of patients with age-related cataracts. By negatively regulating the expression of SIRT1, miR-211 promotes lens epithelial cell apoptosis and inhibits lens epithelial cell proliferation.

Msx2 plays a critical role in lens epithelium cell cycle control

AIM: To investigate the effects of Msx2 on lens epithelium cell cycle, and evaluate the changes of the proliferation, apoptosis of lens epithelium cells. METHODS: Mice lens epithelium cells were cultured and transfected with pEGFP-Msx2 and control. Msx2-deficient mice (Msx2(-/-)) lens tissue were isolated. Lens tissue and transfected cells were prepared for mRNA extraction using Trizol reagent. CyclinD1 and Prox1 expression were evaluated by real-time RT-PCR. BrdU incorporation and apoptosis rate were investigated by immunofluorescence and flow cytometry analysis. RESULTS: After transfected with pEGFP-Msx2, lens epithelium cells failed to incorporate BrdU and anti - phospho-histone-3 immunofluorescence failed to detect cell nuclei which GFP were positive. Msx2 over expression resulted in increasing apoptosis rate in lens epithelium cells. CyclinD1 and Prox1 expression increased significantly in Msx2 knockout mice by real time RT-PCR quantization and CyclinD1 expression decreased significantly in Msx2overexpressed cell. CONCLUSION: Msx2 has the effect of inhibiting proliferation and differentiation, triggering apoptosis on mice lens epithelium cells.

Optimal incision sites to reduce corneal aberration variations after small incision phacoemulsification cataract surgery

AIM： To analyze the effect of steep meridian small incision phacoemulsification cataract surgery on anterior,posterior and total corneal wavefront aberration.· METHODS： Steep meridian small incision phacoemulsification cataract surgery was performed in age-related cataract patients which were divided into three groups according to the incision site： 12 o＇clock, 9o＇clock and between 9 and 12 o＇clock（BENT） incision groups. The preoperative and 3-month postoperative root mean square（RMS） values of anterior, posterior and total corneal wavefront aberration including coma,spherical aberration, and total higher-order aberrations（HOAs）, were measured by Pentacam scheimpflug imaging. The mean preoperative and postoperative corneal wavefront aberrations were documented.·RESULTS： Total corneal aberration and total lower-order aberrations decreased significantly in three groups after operation. RMS value of total HOAs decreased significantly postoperatively in the 12 o＇clock incision group（P 〈0.001）. Corneal spherical aberration was statistically significantly lower after steep meridian small incision phacoemulsification cataract surgery in BENT incision group（P 〈0.05） and Pearson correlation analysisindicated that spherical aberration changes had no significant relationship with total astigmatism changes in all three corneal incision location.·CONCLUSION： Corneal incision of phacoemulsification cataract surgery can affect corneal wavefront aberration.The 12 o＇clock corneal incision eliminated more HOAs and the spherical aberrations decreased in BENT incision group obviously when we selected steep meridian small incision. Cataract lens replacement using wavefront-corrected intraocular lens combined with optimized corneal incision site would improve ocular aberration results.

Changes in corneal endothelial cell density in patients with primary open-angle glaucoma

BACKGROUND Glaucoma is a group of diseases characterized by a specific pattern of optic nerve neuropathy and retinopathy.Increasing evidence demonstrates glaucoma associated corneal endothelium loss.Direct-compression mechanism due to elevated intraocular pressure(IOP),cell toxicity after long term exposure to preservatives and glaucoma surgery have been reported to be the possible mechanism.Herein,we compare the specular endothelial microscopy in primary open-angle glaucoma(POAG)patients and healthy controls of the same age group to observe the corneal endothelium changes and the correlations to the mean IOP in a Chinese case control study.AIM To investigate corneal endothelial cell density in Chinese patients with POAG.METHODS A case control study was performed on 60 eyes of 60 patients with POAG.Exclusion criteria included history of corneal diseases,intraocular diseases,contact lens use,ocular trauma or surgery(including intraocular surgery and laser treatment),congenital abnormalities or systemic diseases such as diabetes.Intraocular pressure was measured using Goldmann tonometry.Indirect specular microscopy(TOPCON SP-2000P)was performed on central corneas and endothelial images were acquired.Endothelial cell density,area and cell counts were analyzed.RESULTS Endothelial cell density was 2959±236 cells/mm2 in healthy controls and 2757±262 cells/mm2 in patients with POAG.The POAG eyes had significantly lower endothelial cell density compared to healthy control eyes(P<0.001).In the POAG group,endothelial cell density was 2686±233 cells/mm2 in the patients receiving medication and 2856±272 cells/mm2 in the untreated subgroup.The eyes receiving medication had significantly lower endothelial cell density compared to untreated eyes.There was a negative correlation between cell density and mean IOP(r=-0.286,P=0.004),positive correlation between the average cell area and mean IOP(r=0.228,P=0.022),maximum cell area and mean IOP(r=0.218,P=0.029)and minimum cell area and mean IOP(r=0.290,P=0.003).The percentage of hexagonal cells was not correlated with mean IOP.CONCLUSION Patients with POAG have lower corneal endothelial cell density than healthy controls of the same age.This may be attributed to mechanical damage from elevated IOP and toxicity of glaucoma medications.