Clinical Manifestations and Surgical Outcomes of Primary Rhegmatogenous Retinal Detachment in Patients < 30 Years of Age with High Myopia

Primary rhegmatogenous retinal detachment(RRD)is a major cause of visual impairment.Extensive studies have shown that high myopia is a significant risk factor for RRD[1].A bimodal age distribution of RRD has been reported in Chinese populations,with a major peak in the group of 60–69 years old and a smaller peak in the group of 20–29 years old[2].A study in China has revealed a similar distribution and further indicated that the proportion and number of patients with RRD and high myopia peaked at the age range of 20–29 years[3].Correspondingly,a high prevalence of myopia has been reported in Asians aged 20–29 years[4].Thus,patients<30 years with RRD and high myopia require special attention.However,limited studies have been conducted on RRD in young individuals with high myopia.Therefore,this study aimed to describe the clinical characteristics and surgical outcomes of patients<30 years with RRD and high myopia.Furthermore,we focused on various factors that may correlate with surgical outcomes.

Combined application of CIRCLE Software and Topo-LASIK for SMILE enhancement

Dear Editor,We present a case of combined application of CIRCLE software(Carl Zeiss Meditec AG,Germany)and topography-guided laser-assisted in situ keratomileusis(Topo-LASIK)for small-incision lenticule extraction(SMILE)enhancement.SMILE is a safe,minimally invasive corneal laser surgery using a femtosecond laser to create an extractable stromal lenticule.

Ten-year observation of corneal densitometry and associated factors following small incision lenticule extraction

●AIM:To investigate the long-term changes of corneal densitometry(CD)and its contributing elements after small incision lenticule extraction(SMILE).●METHODS:Totally 31 eyes of 31 patients with mean spherical equivalent of-6.46±1.50 D and mean age 28.23±7.38y were enrolled.Full-scale examinations were conducted on all patients preoperatively and during followup.Visual acuity,manifest refraction,axial length,corneal thickness,corneal higher-order aberrations,and CD were evaluated.●RESULTS:All surgeries were completed successfully without complications or adverse events.Ten-year safety index was 1.17±0.20 and efficacy 1.04±0.28.CD value of 0–6 mm zones in central layer was statistically significantly lower 10y postoperatively,compared with preoperative values(0–2 mmΔ=-1.62,2–6 mmΔ=-1.24,P<0.01).There were no correlations between CD values and factors evaluated.●CONCLUSION:SMILE is a safe and efficient procedure for myopia on a long-term basis.CD values get lower 10y postoperatively,whose mechanism is to be further discussed.

Clinical and laboratory features of PCR-confirmed periocular tuberculosis in China

Experts lack knowledge of periocular tuberculosis（TB） in China. Nested polymerase chain reaction（PCR） shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory features of PCR-confirmed periocular TB. We retrospectively reviewed medical records of presumptive periocular TB and performed nested PCR test to confirm diagnosis. Nine cases were recruited. Clinical symptoms were chronic and insidious. Eight cases achieved favorable visual acuity, while one underwent enucleation due to fungalTB panophthalmitis. Sensitivity of caseous necrosis, acidfast bacilli（AFB） staining and interferon γ release assay（T-SPOT） test are 33.3%, 44.4% and 85.7% respectively. Low lymphocyte percentage（P=0.019） and high monocytelymphocyte ratio（P=0.042） positively correlate with AFB staining. Male gender（P=0.048） and Langhans giant cell（P=0.048） positively correlate with caseous necrosis. To conclude, traditional TB ancillary tests are not as sensitive as nested PCR technique. Several factors facilitate diagnosis including male gender, decreased lymphocytes, and typical Langhans giant cells.

Clinical Characteristics of Macular Hole and Macular Epiretinal Membrane in Dominant and Nondominant Eyes

Ocular dominance(OD) is referred to the superiority of one eye over the other when the visual sense is produced[1]. This condition can be considered as a preference for the particular laterality of the eye during a mono-visual task or the relative contributions of visual signal transduction between eyes[2]. Empirically, OD tendencies are exhibited in habitual and subconscious behavior.

Refractive outcomes and optical quality of PRESBYOND laser-blended vision for presbyopia correction

AIM: To investigate the one-year refractive outcomes and optical quality following PRESBYOND laser-blended vision(LBV).METHODS: This retrospective study included 20 patients who underwent PRESBYOND treatment between Jan 2019 and Aug 2020. The patients were asked to attend a followup outpatient visit one year after surgery. Distance and near visual acuity as well as subjective refraction were examined. Optical quality was assessed using wavefront-supported custom ablation. A questionnaire evaluating optical quality and satisfaction was completed at the last visit.RESULTS: The average patient age was 48.1±7.4 y(range, 41 to 58 y). The mean preoperative spherical equivalent was-7.59±2.39D. At the one-year follow-up, two eyes(both dominant eyes) lost one line of corrected distance visual acuity(CDVA), while the remaining eyes(38/40) maintained or gained lines of CDVA. The average binocular uncorrected distance visual acuity improved from 0.15±0.03 to 0.90±0.26(decimal vision;P<0.001). The average binocular uncorrected near visual acuity increased from 0.34±0.28 to 0.97±0.07(P<0.001). The spherical aberration was 0.04±0.06 μm in the nondominant eye and 0.09±0.09 μm in the dominant eye(P=0.02). All patients were satisfied with or accepted the outcomes of the surgery. The primary complaints were related to disturbances in night vision and relatively inferior near vision.CONCLUSION: Over the one-year observation period, PRESBYOND is a safe and effective option for presbyopia correction. The optical quality and near vision deserve further investigation.

One-step viscoelastic agent technique for ICL V4c implantation for myopia

AIM:To investigate the safety and efficacy of using a onestep viscoelastic agent technique for posterior chamber phakic implantable collamer lens with a central hole(ICL V4 c)implantation for myopia correction.METHODS:The one-step viscoelastic agent technique for ICL V4 c implantation was used in 100 eyes of 52 patients.Refractive outcomes,intraocular pressure(IOP),corneal endothelial cell,and corneal densitometry values were evaluated at 1 d,1 wk,1 and 3 mo postoperatively.RESULTS:All the surgeries were uneventful.No corrected distance visual acuity was lost after 3 mo.IOP was 16.12±3.18 mm Hg before surgery,and 14.74±3.08 mm Hg at 1d and 14.50±2.56 mm Hg at 3 mo after surgery(P<0.05).Corneal endothelial cell density was 2580±242 cell/mm^(2),the coefficient of variation in cell size was 42.11%±7.92%,and the percentage of hexagonal cells was 40.98%±9.46%before surgery.No significant difference was found when these outcomes were compared between the studied time points(P>0.05).The corneal densitometry values of the central 2 mm and 2 to 6 mm areas showed similar regularities.After surgery,the values significantly increased at 1 d,then decreased to the preoperative values at 1 wk,and then continued to decrease at 3 mo(P<0.05).CONCLUSION:The one-step viscoelastic agent technique for ICL V4c implantation is found to be safe and effective for myopia correction and causes little disturbance to the cornea.

Microarray expression profile and functional analysis of circular RNAs in choroidal neovascularization

Choroidal neovascularization(CNV) is a leading cause of visual loss in age-related macular degeneration(AMD). However, the molecular mechanism for CNV progression is still unclear. This study aimed to identify CNV-related circular RNAs(circRNAs), a novel class of non-coding RNAs with diverse functions. A total of 117 circRNAs were differentially expressed in the murine CNV model by microarrays. Gene ontology(GO)enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) analysis were performed to identify the functions of selected circRNAs. The host genes of these circRNAs were predicted to be targeted to neurogenesis(ontology: biological process), proteinaceous extracellular matrix(ECM)(ontology: cellular component), and binding(ontology: molecular function). Differentially expressed circRNAs-mediated regulatory networks were enriched in ECM receptor interaction. Most of the dysregulated circRNAs could potentially bind to five different mi RNAs by Target Scan and mi Randa. Specifically, circ_15752 was identified in this circRNAs pool which may facilitate vascular endothelial cell proliferation, migration, and tube formation, suggesting a critical role in endothelial angiogenesis. Our work suggests that dysregulated circRNAs may be involved in CNV pathogenesis and serve as potential biomarkers for CNV.

Evaluation of axial length/total corneal refractive power ratio as a potential marker for ocular diagnosis of Marfan’s syndrome in children

AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate.The biological characteristics,including age,sex,AL,and TCRP,were collected from medical records.Receiver operating characteristic(ROC)curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects.The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59.RESULTS:Of 96 subjects(mean age 7.46±3.28 y)evaluated,56(110 eyes)had a definite diagnosis of MFS in childhood based on the revised Ghent criteria,41(82 eyes)with diagnosis of congenital ectopia lentis(EL)were included as a control group.AL was negatively correlated with TCRP,with a linear regression coefficient of-0.36(R2=0.08).A significant correlation was found between age and the AL/TCRP ratio(P=0.023).ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59.MFS patients were present in 24/58(41.38%)patients with an AL/TCRP ratio of≤0.59 and in 34/39(87.18%)patients with an AL/TCRP ratio of>0.59.CONCLUSION:An AL/TCRP ratio of>0.59 is significantly associated with the risk of MFS.The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS.Changes in the AL/TCRP ratio should be monitored over time.

Impact of binocular visual field loss on driving performance in glaucoma patients

AIM:To evaluate the driving performance in young and middle-aged Chinese glaucoma patients with mild to severe visual field loss compared to those without glaucoma by using a driving simulation test.METHODS:Twenty-nine participants were included in this study:nine patients with glaucoma but pass the binocular Esterman visual field test,ten patients with glaucoma and fail the binocular Esterman visual field test,and ten age-matched healthy controls.A driving simulation test was designed as a frequency-based analysis of a lanekeeping task.The total performance error,the controlresponse amplitude and delay were calculated.RESULTS:Esterman visual field test fail group showed the longest delay of control-response among three groups(P=0.02).And the delay in lane-keeping task was significantly associated with inferior field of better-eye(r=0.51,P=0.004)and integrated visual field(r=0.55,P=0.002).CONCLUSION:Young and middle-aged glaucoma patients with binocular visual field loss suffered from a longer delay of response in driving simulation test,while inferior visual field having more impact than superior visual field.

Microstructural features of parapapillary gamma zone and beta zone in non-myopic eyes

Background:To investigate the microstructural features of parapapillary gamma zone and beta zone and their relationship with three-dimensional optic disc shape in non-myopic eyes.Methods:This cross-sectional study included 62 non-myopic eyes with parapapillary gamma or beta zone and 70 control eyes.On the spectral domain optical coherent tomography(SD-OCT)images,we measured the area of gamma zone and beta zone,the length of border tissue,and related disc parameters.The disc ovality index,disc rotation degrees around three axes,Bruch’s membrane opening(BMO)ovality ratio were calculated based on the SD-OCT images.Results:The parapapillary gamma zone composed by externally oblique border tissue was found in inferior,nasal and temporal quadrants of the non-myopic eyes.The presence of gamma zone in non-myopic eyes was correlated with smaller disc ovality index,larger rotation degree around vertical and horizontal axes,and larger BMO ovality ratio(P<0.001).Compared with the non-temporal gamma zone group,eyes with temporal gamma zone had a longer axial length and rotated more around vertical axes(P<0.001).Multivariate analysis showed that the area of gamma zone was correlated with the disc ovality index(P<0.001).The presence and area of beta zone was correlated with age(P<0.01).Conclusions:In non-myopic eyes,the parapapillary gamma zone composed by external oblique border tissue was significantly associated with the disc ovality and disc rotations around vertical and horizontal axes.From a biomechanical perspective,parapapillary gamma zone may contribute to the optic disc stability in association with the structure of BMO.

Repeatability and reproducibility of corneal higher-order aberrations measurements after small incision lenticule extraction using the Scheimpfug-Placido topographer

Background:To evaluate the precision of corneal higher-order aberrations measurements after small incision lenticule extraction(SMILE)using the Sirius Scheimpfug-Placido topographer(CSO,Italy).Methods:Seventy-fve eyes from 75 postoperative subjects were included in this prospective study.Three consecutive corneal aberrometric measurements were obtained with the Scheimpfug-Placido topographer by two experienced operators to assess intra-and inter-observer reproducibility.The within-subject standard deviation(Sw),test-retest repeatability(TRT)and the intraclass correlation coefcient(ICC)were calculated.Results:For intraobserver repeatability of anterior and total corneal aberrations,all ICCs were more than 0.922,except for trefoil(0.722 to 0.768).The ICCs of total root mean square(RMS),coma Z(3,±1),and spherical aberration Z(4,0)were over 0.810 while higher-order RMS,trefoil Z(3,±3),and astigmatism II Z(4,±2)were below 0.634 for posterior corneal surface aberrations.All Sw values for all types of aberrations were equal to or below 0.07μm.Regarding interobserver reproducibility,all TRT values were no more than 0.12μm,0.05μm,and 0.11μm for anterior,posterior,and total corneal aberrations,respectively.The ICC values ranged from 0.875 to 0.989,from 0.686 to 0.976 and over 0.834 for anterior,posterior,and total corneal aberrations,respectively.Conclusions:The repeatability of measurements of anterior and total corneal aberrations with the Sirius system in corneas after SMILE surgery was high,except for trefoil.There was some variability in posterior corneal aberrometric measurements.High reproducibility of corneal aberrometric measurements was observed between measurements of both examiners,except for trefoil,with poor to moderate reproducibility.

Wide‑field swept‑source OCT angiography of the periarterial capillary‑free zone before and after anti‑VEGF therapy for branch retinal vein occlusion

Background:The aim of the study was to investigate the changes in the periarterial capillary-free zone(paCFZ)after anti-vascular endothelial growth factor(VEGF)therapy in patients with branch retinal vein occlusion(BRVO)by widefield swept-source optical coherence tomography angiography(SS-OCTA)and assess their associations with clinical outcomes.Methods:In this retrospective observational study of 54 treatment-naive BRVO patients with macular edema,we reviewed the findings of 12×12 mm^(2)SS-OCTA at baseline,3,6,and 12 months after intravitreal ranibizumab injections.The paCFZ and major retinal artery areas were measured on SS-OCTA images.The paCFZ area to artery area(P/A)ratio was calculated.Results:The paCFZ areas and P/A ratios of first-and second-order arteries were significantly greater in BRVO eyes than in contralateral eyes(all P<0.01),but there were no differences in the first-and second-order artery areas(P=0.20 and 0.25,respectively).The paCFZ areas and P/A ratios decreased significantly at 3,6,and 12 months after anti-VEGF therapy(all P<0.01).The baseline P/A ratio was significantly correlated with the baseline best-corrected visual acuity(BCVA),central retinal thickness,and their improvements at 3,6,and 12 months(all P<0.05).Baseline BCVA and P/A ratios of first-and second-order arteries were independently associated with the final BCVA in multivariate linear regression.Conclusions:Wide-field SS-OCTA shows that anti-VEGF therapy can lead to a significant improvement in the paCFZ parameters in BRVO.Smaller baseline P/A ratios on SS-OCTA tend to predict better visual outcomes at 12 months after anti-VEGF therapy.

The influence of corneal ablation patterns on prediction error after cataract surgery in post-myopic-LASIK eyes

Purpose:To evaluate the influence of corneal ablation patterns on the prediction error after cataract surgery in postmyopic-LASIK eyes.Methods:Eighty-three post-myopic-LASIK eyes of 83 patients that underwent uneventful cataract surgery were retrospectively included.Predicted postoperative spherical equivalence(SE)was calculated for the implanted lens using the Haigis-L and Barrett True-K formula.Prediction error at one month postsurgery was calculated as actual SE minus predicted SE.For each eye,area and decentration of the ablation zone was measured using the tangential curvature map.The associations between prediction errors and corneal ablation patterns were investigated.Results:The mean prediction error was-0.83±1.00 D with the Haigis-L formula and-1.00±0.99 D with the Barrett True-K formula.Prediction error was positively correlated with keratometry(K)value and negatively correlated with ablation zone area using either formula,and negatively correlated with decentration of the ablation zone using the Barrett True-K formula(all P<0.05).In the K<37.08 D group,prediction error was negatively correlated with decentration of the ablation zone with both formulas(all P<0.05).Multivariate analysis showed that with the Haigis-L formula,prediction error was associated with axial length(AL),K value and decentration,and with the Barrett True-K formula,prediction error was associated with AL and decentration(all P<0.05).Conclusion:A flatter cornea,larger corneal ablation zone and greater decentration will lead to more myopic prediction error after cataract surgery in post-myopic-LASIK eyes.

Application of total keratometry in ten intraocular lens power calculation formulas in highly myopic eyes

Background:The accuracy of using total keratometry(TK)value in recent IOL power calculation formulas in highly myopic eyes remained unknown.Methods:Highly myopic patients who underwent uneventful cataract surgery were prospectively enrolled in this prospective comparative study.At one month postoperatively,standard deviation(SD)of the prediction errors(PEs),mean and median absolute error(MedAE)of 103 highly myopic eyes were back-calculated and compared among ten formulas,including XGboost,RBF 3.0,Kane,Barrett Universal II,Emmetropia Verifying Optical 2.0,Cooke K6,Haigis,SRK/T,and Wang-Koch modifications of Haigis and SRK/T formulas,using either TK or standard keratometry(K)value.Results:In highly myopic eyes,despite good agreement between TK and K(P>0.05),larger differences between the two were associated with smaller central corneal thickness(P<0.05).As to the refractive errors,TK method showed no differences compared to K method.The XGBoost,RBF 3.0 and Kane ranked top three when considering SDs of PEs.Using TK value,the XGboost calculator was comparable with the RBF 3.0 formula(P>0.05),which both presented smaller MedAEs than others(all P<0.05).As for the percentage of eyes within±0.50 D or±0.75 D of PE,the XGBoost TK showed comparable percentages with the RBF 3.0 TK formula(74.76%vs.66.99%,or 90.29%vs.87.38%,P>0.05),and statistically larger percentages than the other eight formulas(P<0.05).Conclusions:Highly myopic eyes with thinner corneas tend to have larger differences between TK and K.The XGboost enhancement calculator and RBF 3.0 formula using TK showed the most promising outcomes in highly myopic eyes.

Effects of lighting conditions and accommodation on the three-dimensional position of Visian implantable collamer lens

Background To investigate the effects of lighting conditions and accommodation on the three-dimensional position of Visian implantable collamer lens(ICL V4c).Methods This observational study recruited 62 eyes of 31 myopia patients underwent ICL V4c implantation.Anterior segment optical coherence tomography(AS-OCT)assessed the anterior chamber depth(ACD),ACD-ICL(distance from the corneal endothelium to anterior surface of the ICL V4c),vault(distance between the posterior ICL V4c surface and anterior crystalline lens surface),and crystalline lens tilt under various lighting conditions and accommodation relative to the corneal topographic axis at one year after ICL V4c implantation.Baseline was defined as the scotopic condition,which was also the non-accommodative stimulus condition.The ICL V4c tilt was analyzed using MATLAB.The significance level was set at P<0.05.Results The ACD-ICL values were similar under various lighting conditions(P=0.978)but decreased during accommodation(P<0.001).The vault was significantly smaller under mesopic and photopic conditions than the baseline(P=0.044 and P<0.001,respectively)but remained unchanged during accommodation(P=0.058).The inferotemporal proportion of ICL V4c(88.7%,55 eyes)and crystalline lens(74.2%,46 eyes)tilts were not significantly different(P=0.063).Crystalline lens under various lighting conditions and accommodation exhibited similar tilts.The vertical tilt of ICL V4c was significantly larger under photopic conditions than the baseline(P=0.038).The horizontal and total tilts were significantly decreased during accommodation(P=0.043 and 0.013,respectively).Conclusions The axial position of ICL V4c in the anterior chamber was stable under various lighting conditions.Lighting conditions and accommodation may influence vertical,horizontal and total tilts of ICL V4c.

Optical coherence tomography angiography metrics in different stages of diabetic macular edema

Background To investigate the optical coherence tomography angiography(OCTA)characteristics of diabetic macular edema(DME)at different stages.Methods This study was a cross-sectional study.Patients diagnosed with DME were recruited.DME was classified into early,advanced,and severe DME.The vessel density(VD)in the superficial vascular plexus(SVP),deep vascular plexus(DVP)and foveal avascular zone(FAZ)parameters,including FAZ area,FAZ perimeter,acircularity index and foveal VD in a 300-μm-wide region around the FAZ(FD-300),were calculated by the AngioVue software.A multivariate generalized estimating equation was used to evaluate the associations between visual acuity and OCTA metrics.Results Ninety-two eyes from 74 patients with DME were included in this study.Compared to early(P=0.006)and advanced DME(P=0.003),the acircularity index was higher in severe DME.Both whole and parafoveal VD in the DVP decreased in eyes with severe DME compared to early DME(P=0.018,P=0.005,respectively)and advanced DME(P=0.035,P=0.012,respectively).In the multivariate generalized estimating equation,DME severity,FAZ area and foveal thickness were positively associated with worse visual acuity(P=0.001,P=0.007 and P=0.001,respectively).Conclusion Compared to early and advanced DME,severe DME showed increased irregularity in the FAZ and more extensive vessel damage in the DVP.Greater severity level of DME,larger FAZ area,and increased foveal thickness could be risk factors for poor visual acuity.Trial registration The protocol was published in the Chinese Clinical Trial Registry(ChiCTR2000033082).

Exosomal miR-29b found in aqueous humour mediates calcium signaling in diabetic patients with cataract

AIM:To investigate the role of exosomal miR-29b and Ca^(2+)in regulating the function of human lens epithelial cells(HLECs).METHODS:Exosomes were isolated from human aqueous humour(AH)by ultracentrifugation,and visualized by nanopar ticle tracking and transmission electron microscopy.Exosomal miRNA sequencing was performed to identify differentially expressed miRNAs between diabetes with cataracts(DMC)group and age-related cataracts(ARC)group.TargetScan was used to predict potential target of certain miRNA.The expression of CACNA1C mRNA was determined by quantitative real-time polymerase chain reaction and CACNA1C protein was determined by Western blotting.Concentration of Ca^(2+)in human AH and the culture supernatant of cells were detected by the calcium assay kit.Cell counting kit-8 was used to determine cell viability.RESULTS:Exosomes were isolated from human AH,which had a typical cup-shaped phenotype and a particle size distribution in accordance with micro extracellular vesicles.Exosomal miRNA sequencing revealed that miR-29b was significantly downregulated in DMC group compared with ARC.Ca^(2+)concentration of human AH in DMC was higher than that in ARC.The culture supernatant of cells transfected with miR-29b inhibitors had a higher concentration of Ca^(2+)than that transfected with miR-29b mimics.miR-29b reduced the viability of HLECs by upregulating CACNA1C expression.CONCLUSION:Exosomes isolated from human AH contains abundant miRNAs.A significantly expressed miR NA,miR-29b,can affect the concentration of Ca^(2+)and regulate HLEC processes by upregulating CACNA1C.

Inhibitory effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system Keke

Background:To evaluate the effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system.Methods:Nine elder cynomolgus monkeys were used,consisting of three monkeys without cataract as controls,three monkeys with naturally occurring cortical cataract,and three monkeys with nuclear cataract as intervention groups.Nanoparticulated thermogel with lanosterol and fluorescein was administered by subconjunctival injection in the monkeys with cataract.Fluorescence changes of injected thermogel and cataract progression were observed.Lanosterol concentration in aqueous humor,solubility changes in lens proteins,and oxidative stress levels were analyzed in the lenses of the control and intervention groups.Results:Injected thermogel showed decreased fluorescence during follow up.Lanosterol concentration in aqueous humor increased in the first 2 weeks and then gradually decreased,which was in accordance with the changes in cortical lens clarity.However,lenses with nuclear opacification showed little change.In the cortical region of lenses with cortical cataract,solubility ofα-crystallin was significantly increased after administration of lanosterol,as well as the reduction of oxidative stress.Conclusions:We demonstrated the effect of lanosterol on cataract progression based on in vivo models of primates.Lanosterol showed a short-term and reliable reversal effect on reducing cataract severity in cortical cataract in the early stages,possibly due to the increase in the solubility of lens proteins and changes in the oxidative stress status.Lanosterol administration using subconjunctival drug release system could be a promising nonsurgical approach for future clinical studies of cataract prevention and treatment.

Decentration and tilt of plate-haptic multifocal intraocular lenses in myopic eyes

Background:To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses(MfIOLs)in myopic eyes.Methods:Myopic(axial length[AXL]>24.5 mm)and non-myopic(21.0 mm<AXL≤24.5 mm)cataract eyes were enrolled in this prospective study and randomly assigned to receive implantation of Zeiss AT LISA tri 839MP lenses(Group A)or Tecnis ZMB00 lenses(Group B).In total,122 eyes of 122 patients were available for analysis.Decentration and tilt of MfIOLs,high-order aberrations(HOAs),and modulation transfer functions(MTFs)were evaluated using the OPD-Scan III aberrometer 3 months postoperatively.Subjective symptoms were assessed with a Quality of Vision questionnaire.Results:Near and distance visual acuities,tilt and horizontal decentration did not differ between the two groups,postoperatively.However,myopic eyes of Group B showed greater vertical decentration than those of Group A(−0.17±0.14 mm vs.-0.03±0.09 mm,respectively),particularly when the MfIOLs were placed horizontally or obliquely.Overall decentration of myopic eyes was greater in Group B than in Group A(0.41±0.15 mm vs.0.16±0.10 mm,respectively).In Group B,AXL was negatively correlated with vertical decentration and positively correlated with overall decentration.No such correlations were found in Group A.Intraocular total HOAs,coma,trefoil and spherical aberrations were lower in Group A than in Group B for a 6.0 mm pupil among myopic eyes.Generally,Group A had better MTFs and fewer subjective symptoms than Group B among myopic eyes.Conclusions:Plate-haptic design of MfIOLs may be a suggested option for myopic cataract eyes due to the less inferior decentration and better visual quality postoperatively.