Introduction The study compared visual acuity and refractive outcomes of Eyecryl TM SERT and TECNIS Eyhance™ IOLs following cataract surgery as part of a broader prospective evaluation. Methods This is a prospective, non-randomized comparative study of cataract patients implanted with either IOL. Postoperative assessments were conducted at Day 1, Week 2, and Month 6. Outcomes included corrected and uncorrected distance, near, and intermediate visual acuity, intraocular pressure, and refractive parameters. Results The study included 120 eyes (60 per group). At 6 months, Eyecryl™ SERT demonstrated better monocular and binocular DCIVA than TECNIS Eyhance™ (0.10 ± 0.08 vs . 0.15 ± 0.08 logMAR; p < 0.0001 and 0.07 ± 0.06 vs . 0.11 ± 0.09 logMAR; p = 0.0021, respectively). Binocular UCIVA also favored Eyecryl™ SERT (0.09 ± 0.08 vs . 0.16 ± 0.09 logMAR; p = 0.0005), while monocular UCIVA was comparable between groups. Both groups showed significant improvement in monocular UDVA and BCDVA from baseline, with no significant inter-group differences. Binocular UDVA and BCDVA remained stable in both groups, with no significant intra- or inter-group differences. TECNIS Eyhance™ showed significantly better monocular and binocular UNVA and better binocular DCNVA, whereas monocular DCNVA was comparable between groups. IOP remained within normal limits, and refractive parameters were comparable between groups. Discussion Visual acuity assessment across multiple distances under monocular and binocular conditions helped identify optical trade-offs and suitability for visual rehabilitation. Conclusion Eyecryl™ SERT demonstrated better intermediate vision compared to TECNIS Eyhance™ following cataract surgery, with both lenses showing favorable safety profiles over 6 months.
Introduction/Objective Diabetic cataract is driven by hyperglycemia-associated oxidative/nitrosative stress, inflammation, apoptosis, activation of the polyol pathway, and lens protein glycation. Hesperidin (HSN) and Naringenin (NGN) are citrus flavonoids with antioxidant, anti-inflammatory, anti-apoptotic, and antidiabetic activities. This study evaluated their lens-protective effects in streptozotocin (STZ)-induced diabetic rats. Methods Male Sprague-Dawley rats with STZ-induced diabetes received hesperidin (100 mg/kg/day, orally) or naringenin (50 mg/kg/day, orally) for 10 weeks. Fasting blood sugar, serum insulin, lenticular malondialdehyde, nitric oxide, total antioxidant capacity, TNF-alpha, IL-6, NF-kB p65, Bax/Bcl-2 ratio, cleaved caspase-3, aldose reductase activity, sorbitol concentration, glycated proteins, and total/soluble proteins were assessed. Results STZ significantly increased fasting blood sugar and reduced serum insulin. Diabetic lenses also showed increased levels of malondialdehyde, nitric oxide, TNF-alpha, IL-6, NF-kB p65, Bax/Bcl-2 ratio, cleaved caspase-3, aldose reductase activity, sorbitol, and glycated proteins, with reduced total antioxidant capacity and total/soluble protein levels. HSN and NGN significantly ameliorated these changes versus untreated diabetic rats ( p < 0.05). Discussion The findings indicate that HSN and NGN mitigate biochemical pathways implicated in diabetic lens injury, including oxidative/nitrosative stress, inflammation, apoptosis, polyol-pathway activation, and protein glycation. Conclusion In this STZ-induced rat model, hesperidin and naringenin preserved lens biochemical homeostasis and attenuated diabetes-associated lens injury, supporting their potential as adjunctive candidates for preventing or delaying diabetic lens damage.
Introduction Dry Eye Disease (DED) is a prevalent eye condition, with Type 2 Diabetes (T2D) being a risk factor for DED. However, there remains limited up-to-date national research on the association and etiological relationship between Type 2 diabetic retinopathy and dry eye disease (DR-DED). This study aims to compare glycemic biomarkers and ocular surface health in patients with DR-DED and those with DR-only. Methods This is a pilot exploratory study; we included adult patients (aged ≥ 18) with type 2 diabetes (T2D). This study consists of two groups: DR-DED (n=11) and DR-only (n= 7). Type 1 diabetes mellitus patients, patients with terminal diagnoses such as cancer, and patients who use chemotherapy as a treatment were excluded. All the patients' data were collected from the electronic health system of the Ibsar Specialist Center between January 2023 and December 2023. Statistical analysis was performed with GraphPad Prism. Continuous data were presented as medians with Interquartile Ranges (IQR), and categorical variables were presented as frequencies and percentages. Between-group comparisons were performed using relevant nonparametric statistical tests. Correlations between variables were tested using Spearman’s rank correlation coefficient. A two-sided P value of <0.05 was considered statistically significant. Results The DR-DED group showed decreases in both ocular tests (Tear break-up time and Schirmer test) compared to the DR-only group, with statistically significant differences ( P < 0.0010 and P < 0.0052, respectively). In addition, the median fasting blood glucose level was lower in the DR-DED group than in the DR-only group, but the difference was not statistically significant. Glycated hemoglobin (HbA1c) was not different across groups. The DR-DED group presented a higher prevalence of systemic comorbidities. The DR-only group was more frequently treated with oral antidiabetic medications instead of insulin. There was a negative correlation, with no statistically significant difference, between HbA1c levels and Schirmer test scores in the DR-DED group, whereas the opposite was observed in the DR-only group. Discussion: This pilot study reports that DR-DED patients have blood glycemic biomarkers similar to those in patients with DR-only but differ in ocular surface health. Additionally, DR-only patients taking insulin injections showed improvements in ocular surface health compared to DR-DED patients. Consequently, it is recommended to perform ocular surface screenings as routine alongside routine retinopathy checks to manage early diagnosis of DED in DR populations. Conclusion This study shows that patients with DR-DED had a significantly greater ocular tear health burden than those with DR alone, even though their blood sugar levels were controlled to the same extent. These data indicate that factors beyond glycemic management may contribute to ocular surface deterioration in patients with diabetic retinopathy. Further investigation of hypothesized pathways and the influence of systemic treatment on ocular outcomes would require larger prospective studies.
Introduction Childhood myopia has become a major public health concern worldwide. This study investigated the prevalence, severity, and behavioral factors associated with myopia among primary schoolchildren in Nghe An province, Vietnam. Methods A school-based cross-sectional study was conducted among 9,498 boys and girls aged 6-10 years from 10 primary schools. Distance visual acuity screening was followed by refractive assessment using autorefractometry and retinoscopy. Behavioral and familial information was collected using structured questionnaires. Multivariable and ordered logistic regression models accounting for school clustering were used to identify factors associated with myopia and its severity. Results The prevalence of myopia was 20.7% (1,966/9,498); 68.9%, 25.1%, and 6.0% had low, moderate, and high myopia, respectively. A near-work distance ≥30 cm was associated with lower odds of myopia (adjusted odds ratio [aOR] 0.22, 95% CI 0.19-0.26), whereas extra study time >2 hours/day (aOR 1.63, 95% CI 1.32-2.00) and screen exposure ≥2 hours/day (aOR 1.44, 95% CI 1.26-1.65) increased the risk. Outdoor activity ≥3 hours/day was protective (aOR 0.48, 95% CI 0.40-0.57). The same behavioral factors were also independently associated with greater myopia severity. Discussion These findings support previous evidence that modifiable lifestyle behaviors influence both myopia occurrence and severity. However, causal relationships cannot be inferred because of the cross-sectional design. Conclusion Reading distance, extra study time, screen exposure, and outdoor activity were independently associated with myopia occurrence and severity. Promoting healthy visual habits and increasing outdoor activity should be prioritized in school-based myopia prevention programs.
Introduction/Objective The purpose of this research is to retrospectively analyze diabetic mouse retina datasets to obtain new insights into Diabetic Retinopathy (DR).Methods In this study, we performed single-cell RNA-sequencing (scRNA-seq) on combined diabetic mice retina datasets obtained from previous studies and validated the findings using real-time PCR.Results Our findings revealed that the final glucose level, compared to disease progression duration, determines diabetic severity. Pseudobulk RNA-seq analysis of key cell types, such as Endothelial Cells (ECs), microglia, and Retinal Ganglion Cells (RGCs), showed notable communication pathways between them that outweigh even the immune-related responses during hyperglycemia. Lastly, cell-cell communication analysis mapped out notable communication pathways among the three cell types. In essence, ECs secrete more Igfbp3 and less Cxcl12 to Tmem219 receptors on microglia and Ackr3 receptors on RGCs, respectively.Discussion Current clinical therapy can only slow disease progression in the retina but not reverse it. Accordingly, the elucidation of early biomarkers for detection is preferred. These results provide potential targets that can be regulated for detection or therapeutic purposes.Conclusion Our results indicate that the severity of diabetes is primarily determined by the final blood glucose level, rather than the length of time the disease has progressed. Secondly, our analysis demonstrated significant crosstalk between ECs, microglia, and RGCs that outweighs the significance of immune-related responses when the retina was exposed to extreme levels of blood glucose. Lastly, we validated these communication pathways, specifically Cxcl12-Ackr3 and Igfbp3-Tmem219, to be uniquely initiated by the ECs to RGCs and microglia, respectively.
Objective: The objective of this study was to evaluate whether the combination of low-dose atropine (LDA) and peripheral defocus lenses (Defocus Incorporated Multiple Segments, DIMS) provides additional benefit for children undergoing myopia management. Methods: This was a retrospective study including fifty-one patients aged 8 to 13 years who attended a private clinic between January 2020 and September 2021. Subjects were selected based on documented myopia progression of >= 0.50 D/year during the previous 12 months. Following the initial diagnosis of myopia, participants were advised to spend at least 2 hours per day outdoors for 6 months (Phase 1 - environmental control). If axial length (AL) increased by > 0.15 mm during this period, participants were prescribed nightly LDA (0.025%) for the following 12 months (Phase 2 - monotherapy). If, at the 12-month visit, AL continued to increase by > 0.17 mm/year, combination treatment with LDA and DIMS lenses was initiated for a further 12 months. Only data from the right eye were analyzed. Treatment efficacy was evaluated by comparing the differences in myopia progression across the treatment periods. Results: The mean age of patients was 10.16 +/- 1.63 years. Males comprised 25 (49.02%) of the subjects. At baseline, the mean spherical equivalent refraction, median keratometry, and AL were -3.01 +/- 1.22 D, 43.13 +/- 1.19 D, and 24.60 +/- 1.03 mm, respectively. At phase 1, the mean progression in AL was estimated to be 0.39 +/- 0.09 mm/year. The combined treatment significantly reduced the progression of myopia compared to LDA monotherapy (0.21 +/- 0.03 versus 0.13 +/- 0.05 mm, p < 0.0001). Discussion: The pharmaceutical intervention that is most frequently employed in clinical settings is atropine 0.01%. Nevertheless, a number of studies demonstrated low efficacy in the long term, particularly when AL elongation was the desired outcome. Additionally, it has been proposed that the most effective LDA tested in the young Asian population is 0.05% atropine; however, in the Western population, there were reports of frequent side effects when using this LDA. The combined treatment using atropine 0.025% was one option to increase the efficiency of reduction in myopia progression. Conclusion: The combination of DIMS spectacle lenses and LDA achieved the greatest reduction in myopia progression, as measured by axial length elongation, compared with LDA monotherapy or environmental control in this Brazilian population. Further randomized, double-blind clinical trials with longer follow-up are warranted to better determine the true impact of this combination therapy on myopia progression.
Objective: This study aimed to determine the relationship between corneal biomechanical properties and refractive status. Methods: The study included patients who underwent routine eye examination and were divided into 3 groups based on refractive status: hyperopia group (spherical equivalent >+0.50 diopters), myopia group (spherical equivalent <-0.50 diopters), and emmetropia group (spherical equivalent within +/- 0.50 diopters). Corneal biomechanical parameters (corneal hysteresis and corneal resistance factor) and intraocular pressure were measured via an ocular response analyzer (Reichert, Corp., Buffalo, NY). Corneal biomechanical properties were compared between the three groups. Pearson's correlation analysis, one-way ANOVA, and multivariate analysis of covariance were used to evaluate the study data. Results: Corneal hysteresis and age were significantly correlated in the hyperopia, myopia, and emmetropia groups based on Pearson's correlation analysis (P<0.05). Corneal hysteresis and corneal resistance factor values were adjusted for the age variable. Mean corneal hysteresis was 11.34 +/- 0.40 mmHg, 11.35 +/- 0.34 mmHg, and 11.65 +/- 0.33 mmHg in the hyperopia, myopia, and emmetropia groups, respectively (P=0.021, one-way ANOVA). Mean corneal resistance factor was 11.05 +/- 0.35 mmHg, 10.85 +/- 0.30 mmHg, and 11.04 +/- 0.29mmHg in the hyperopia, myopia, and emmetropia groups, respectively (P=0.047, one-way ANOVA). Corneal hysteresis and corneal resistance factor were significantly correlated based on Pearson's correlation analysis (P<0.001). Moreover, according to Pearson's correlation analysis, there was no significant correlation between corneal hysteresis and spherical equivalent, but corneal resistance factor and spherical equivalent were significantly correlated (P=0.502 and P=0.001, respectively). Conclusion: Myopes have lower corneal hysteresis and corneal resistance factor than hyperopes and emmetropes. Refractive status should always be a consideration when assessing corneal biomechanical properties.
IntroductionWe, herein, present a rare case report evaluating an elderly patient who developed spontaneous suprachoroidal hemorrhage (SSCH) while using apixaban (direct oral anticoagulant agent). Case PresentationAn 82-year-old man with a known history of hypertension and atrial fibrillation on apixaban presented with a sudden onset of flashes, floaters, and a temporal curtain-like visual field defect in his right eye. He had no preceding history of trauma or recent ocular surgery. Ophthalmological examination revealed two large elevated grayish choroidal lesions with associated exudative retinal detachment. Ultrasonography and wide-field fluorescein angiography confirmed the diagnosis of SSCH. The patient was managed with topical steroids and cyclopentolate. One month later, the vision improved, and the hemorrhage showed signs of resolution. DiscussionDirect oral anticoagulant agents (DOACs) are safer and carry a lower risk of major bleeding events compared to the traditionally used antiplatelet therapy and thrombolytic agents; however, patients may still be at risk of spontaneous suprachoroidal hemorrhage. ConclusionSpontaneous suprachoroidal hemorrhage can very rarely occur with the use of DOACs, with only two cases reported in the literature, and here, we present a case of SSCH in a patient while using apixaban.
Refractive errors, including myopia, hyperopia, and astigmatism, can impair vision and require corrective solutions, such as glasses, contact lenses, or surgical intervention. Photorefractive Keratectomy (PRK) and transepithelial PRK (TPRK) are two surface ablation laser procedures commonly used to correct refractive errors by reshaping the cornea. PRK, a widely used technique, involves mechanical or alcohol-assisted removal of the corneal epithelium before applying an excimer laser to ablate the stromal tissue. Although effective, PRK is associated with post-operative discomfort, longer recovery times, and potential consequences, such as corneal haze and regression. Alternatively, TPRK, introduced as an advancement over PRK, utilizes an excimer laser for both epithelial removal and stromal ablation in a single step, eliminating the need for mechanical scraping or alcohol application. This technique reduces surgical time, minimizes epithelial trauma, and enhances healing, leading to faster visual recovery and less post-operative pain. TPRK maintains similar efficacy to PRK while improving patient comfort and reducing complications. Despite these advantages, both procedures have contraindications and additional postoperative consequences. Moreover, Artificial Intelligence (AI) is increasingly shaping ophthalmology by enhancing diagnostic precision and supporting refractive surgery planning. Machine learning models contribute to improved patient selection, prediction of surgical outcomes, and refinement of procedures such as PRK and TPRK. In this review, we compare visual and refractive outcomes, complications, and patient satisfaction between conventional PRK and TPRK, while also addressing the emerging role of AI in corneal refractive surgery. Further well-designed studies are needed to establish standardized treatment protocols and improve patient-reported clinical outcomes, such as corneal stability and higher-order aberrations.
Introduction Previous studies have suggested that Diabetic Retinopathy (DR) may be linked to disturbed lactate homeostasis, but the exact mechanism remains unclear. In this study, we explored biomarkers related to DR and provided insights into their mechanisms based on Lactylation-Related Genes (LRGs). Methods The GSE185011, GSE60436, and LRGs were employed in this study. Firstly, the differentially expressed genes 1 (DEGs 1) and DEGs 2 were obtained by differential analysis in two datasets, respectively. Then, the common DEGs (CO-DEGs) were selected by integrating the intersection of up-regulated genes from DEGs 1 and DEGs 2, and the down-regulated genes from DEGs 1 and DEGs 2. Next, the candidate biomarkers were identified by overlapping the CO-DEGs and LRGs. Importantly, the biomarkers were further identified using expression analysis. Eventually, based on the biomarkers, GeneMANIA, function enrichment, subcellular localization, and related network analyses of the biomarkers were performed, respectively. Results In this study, 7 candidate biomarkers were identified by overlapping the 262 CO-DEGs and 331 LRGs, all of which exhibited significantly consistent expression trends in GSE185011 and GSE60436. Therefore, they (RECQL, NOC3L, SSB, DDX18, ARID3B, LSP1, TKT) were defined as biomarkers. In GeneMANIA analysis, 20 genes with similar functions were predicted, such as DDX18-GNL2 and SSB-CDC27, which were mainly involved in ribosomal biosynthesis, rRNA metabolic process, etc. Later, function enrichment analysis revealed that biomarkers, except for RECQL, were enriched in ribosome, complement, and coagulation cascade pathways in GSE185011. Additionally, all biomarkers were rich in oxidative phosphorylation, Butanoate metabolism, and other pathways in GSE60436. For subcellular location analysis, ARID3B, DDX18, NOC3L, RECQL, and SSB may be located in the cytoplasm, while LSP1 and TKT might be located in the nucleus. Furthermore, TKT-pentose phosphate pathway genes (PGM2, TALDO1), and SSB-systemic lupus erythematosus genes (SNRPD1, SNRPD3, SNRPB) networks were separately constructed. Meanwhile, a disease-biomarkers-drugs was also built, such as Lipid Metabolism Disorders-NOC3L-Acetaminophen. Discussion Our findings suggest that lactylation-driven metabolic reprogramming and disruptions in DNA/RNA homeostasis are pivotal in DR pathogenesis. These biomarkers offer new insights for understanding molecular mechanisms and developing targeted therapies. Conclusion In this study, RECQL, NOC3L, SSB, DDX18, ARID3B, LSP1, and TKT were identified as biomarkers related to lactylation for DR, which provided a theoretical basis for the study of DR.
Introduction Keratoconus is a bilateral, progressive corneal ectasia characterized by thinning and conical protrusion of the cornea. Its global prevalence is increasing, with higher rates reported in Africa, including Kenya. In Kenyan studies, most patients are diagnosed at advanced stages, where management is often costly, and complications are severe. Early detection enables more effective and affordable interventions with reduced risks. However, accurate early diagnosis requires advanced equipment and clinical expertise. In many low-resource settings, these factors are lacking, resulting in delayed diagnosis and poor outcomes. Strengthening early diagnostic capacity is essential to reduce the burden of advanced keratoconus and prevent avoidable visual impairment. The objective of this study was to assess the level of knowledge among eye care practitioners in the diagnosis and management of early-stage keratoconus in Nyanza and Western Kenya. Methods A cross-sectional study was conducted across hospitals in Nyanza and Western Kenya. A census sampling technique was employed to include all eligible eye care practitioners. Data were collected using a structured questionnaire and analysed using both descriptive and inferential statistical methods to evaluate knowledge levels and associated factors. Results A total of one hundred and thirty-four practitioners completed the questionnaire. Regarding early keratoconus diagnosis, 36.6% demonstrated good knowledge, 60.4% had fair knowledge, and 3.0% exhibited poor knowledge. For early keratoconus management, 36.6% had good knowledge, 61.2% had fair knowledge, and 2.2% reported poor knowledge. A statistically significant association was observed between practitioners’ qualifications and knowledge in early keratoconus management (p=0.006). Discussion A substantial number of practitioners demonstrated limited knowledge of early keratoconus, possibly due to the low rates of keratoconus services, which may ultimately limit their experience. Conclusion Most practitioners demonstrated only fair knowledge in the diagnosis and management of early keratoconus. Practitioners’ qualifications were significantly associated with knowledge in early keratoconus management.
Glaucoma, a leading cause of irreversible blindness worldwide, presents substantial challenges in clinical diagnosis and long-term management due to its often insidious early progression and the irreversible nature of late-stage optic nerve damage. However, rapid advancements in artificial intelligence technologies, particularly in machine learning, deep learning, and large language models, are transforming ophthalmic practice. AI is now being extensively applied across the spectrum of glaucoma care, from screening and precise diagnosis to optimizing treatment and supporting long-term patient management. This review systematically examines the latest applications of AI in glaucoma, highlighting multidimensional innovations. These applications span a wide range, including sophisticated image analysis, the identification of novel molecular biomarkers, prediction of treatment response, and advanced surgical planning. The paper also discusses key challenges and future development directions of these technologies, aiming to provide new insights for glaucoma management.
Purpose The study aimed to compare the efficacy and safety of single or multiple intravitreal triamcinolone acetonide (ITA) injections compared to a single intravitreal dexamethasone implant (IDI) for the treatment of macular edema associated with central retinal vein occlusion (CRVO). Methods Between January 2016 and January 2023, a retrospective study was performed on a total of 60 consecutive eyes, with 30 eyes receiving ITA and the other 30 receiving IDI. Best corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP), and cataract progression were assessed over a follow-up period of 6 months. Results Both ITA and IDI groups showed initial improvements in BCVA and CRT at one month, with no significant difference between the groups. However, at six months, there were no notable disparities in BCVA, CRT, IOP increase, or cataract progression between the two treatments. In the ITA group, BCVA improved from baseline to one month and remained stable until six months. The IDI group showed initial improvement but did not display further significant progress at the six-month mark. No statistically significant difference was found between the groups. Retinal thickness decreased significantly in both groups from baseline to one month and continued to improve until six months, with no significant difference between ITA and IDI. Regarding complications, both groups had similar occurrences of transient IOP increases (40% in each group) and cataract progression (40% in ITA, 20% in IDI). Conclusion At the final follow-up, no statistically significant differences were observed between the two groups in BCVA, CRT, IOP increase, or cataract progression. Despite the cost difference between the two injections, both treatments can be used with similar efficacy and safety profiles.
Introduction: This study compared three surgical approaches for convergence insufficiency intermittent exotropia (CI-X[T]) in children to identify the most effective method. Methods: Fifty-eight children aged 4-13 years with CI-X(T) and near-distance disparity >= 10 prism diopters (PD) were prospectively randomized to: (1) Bilateral Lateral Rectus Recession (BLR), (2) Unilateral Recession-Resection (RR), or (3) Medial Rectus Resection (MRR). Surgical outcomes were defined as postoperative deviation within 5 PD of esophoria/tropia and 10 PD of exophoria/tropia. Patients were followed for 24 months. Results: At the final follow-up, cumulative success rates were similar among BLR (52.4% near, 81.0% at distance), RR (30.4% near, 43.5% at distance), and MRR (27.3% near, 50.0% at distance). Near exodeviation decreased significantly in all groups (p < 0.001). NDD correction was achieved in 59.1% of MRR, 50.0% of BLR, and 30.4% of RR patients (p = 0.142). Stereopsis improved comparably across groups. Complications included overcorrection and A/V patterns in BLR, undercorrection in RR, and persistent consecutive esotropia in MRR. Discussion: All three surgical approaches were effective, with BLR favoring distance correction, RR showing short-term near benefits, and MRR demonstrating balanced long-term outcomes, including improvement in the AC/A ratio. Conclusion: MRR appears to be the most reliable overall, although individual patient characteristics should guide surgical choice. Larger, long-term studies are needed.
Background Several studies have recommended glaucoma drainage devices (GDDs), particularly the use of the Ahmed glaucoma valve, as the primary surgical procedure. Nevertheless, surgical hypotony, capsular fibrosis, and tube failure are among the side effects of these devices. In this study, we report a case of the development of a conjunctival cyst as a complication of the surgical implantation of the Ahmed glaucoma valve device.Case Presentation A 21-year-old man who was diagnosed with bilateral congenital glaucoma presented with a persistently high intraocular pressure even after undergoing bilateral trabeculectomy and trabeculotomy with mitomycin C. After that, Ahmed glaucoma valve was employed, which led to an improvement in IOP postoperatively; however, upon follow-up, we noticed by clinical examination the development of a large encapsulated subconjunctival cyst, and then prompt surgical excision of the cyst was performed.Conclusion Formation of a large conjunctival cyst is one of the complications that can be noticed post-AGV (Ahmed (R) glaucoma valve) use. This case showed the surgical resection of the cyst to be essential and effective. More investigations are needed to address this complication with proper preoperative counselling for any postoperative GGD complications occurring in the patients.
Aims and Objectives : This study aims to explore the effectiveness of iridotomy combined with anterior chamber insufflation for the treatment of Descemet's membrane detachment (DMD) through a scleral tunnel incision. Methods : This is a retrospective study, analyzing 48 DMD patients treated at Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, from December 2012 to October 2024. Patients were divided into a conservative treatment group, a simple anterior chamber air injection group, and an anterior chamber air injection combined with peripheral iridectomy group through through scleral tunnel incision according to different treatment methods. Herein, the patient's preoperative visual acuity, corneal edema, and DMD recovery were observed and recorded on postoperative day 1, 7, and 1 month. Literature was retrieved related to DMD for the past 10 years, which was compared and analyzed for risk factors, treatment methods, and treatment outcomes. Results: The conservative treatment group consisted of 12 cases, with an average age of 73.0 +/- 10.7 (SD) years and an average recovery time of 13.7 days. There were 6 cases in the simple anterior chamber air injection group, with an average age of 68.6 +/- 8.5 (SD) years. On the first day after surgery, all cases of DMD had complete recovery. Among them, 3 cases had elevated intraocular pressure on the first day after surgery, and were treated with anterior chamber deflation and medication to reduce intraocular pressure. Two cases recovered to normal intraocular pressure 3 days after surgery, and 1 case developed ciliary ring block glaucoma. Posterior vitrectomy combined with peripheral iridectomy was performed to control intraocular pressure. Thirty cases of iris peripheral surgery combined with anterior chamber air injection group were considered, with an average age of 70.6 +/- 7.4(SD) years. On the first day after surgery, 2 cases had elevated intraocular pressure, which was restored through drug treatment. One week after surgery, one case of DMD did not recover, but was restored through corneal suturing and anterior chamber insufflation. The remaining 27 patients had normal intraocular pressure, DMD recovery, and resolution of corneal edema on the first day after surgery. In both the simple anterior chamber air injection group and the combination therapy group, there was one case of slight anterior chamber bleeding on the first day after surgery. Postoperative complication rates were significantly lower in the combined group (13.33%) compared to the simple injection group (83.33%, p=0.003).Discussion Anterior chamber air injection effectively reattaches DMD, while adjunctive scleral tunnel iridectomy reduces the risks of postoperative angle closure and IOP elevation. The surgical approach avoids re-injury of DMD and minimizes complications. Conclusion: Combined anterior chamber air injection and scleral tunnel peripheral iridectomy is a safe and effective treatment for DMD, with a low incidence of postoperative complications.
Introduction/objective Effective treatment of retinal vein occlusion (RVO) is critical to improve vision outcomes. Requirements for repeated intravitreal injections highlight the need for treatments with reduced dosing frequency. The open-label, post-approval YANGTZE study (NCT03908307) evaluated dexamethasone implant in Chinese patients with macular edema due to RVO.Methods Eligible patients had previously untreated macular edema due to RVO. Patients received dexamethasone implant 700 mu g and were followed up for 12 months; additional injections were administered based on clinical judgement. Primary endpoints were mean change from baseline (CFB) in best-corrected visual acuity (BCVA), proportion of patients with improvement in BCVA >= 15 letters at month 6, and area under the curve (AUC) of average CFB in BCVA.Results Overall, 70 patients were enrolled and treated with dexamethasone implant (mean: 2.3 injections). Mean +/- standard deviation CFB in BCVA was 10.3 +/- 12.1 letters at month 6 and 10.5 +/- 12.1 letters at month 12 (both p < 0.001 vs. baseline). Improvement from baseline in BCVA of >= 15 letters was reported in 34.3% and 37.1% of patients at months 6 and 12, respectively. AUC analysis of CFB in BCVA showed significant improvement (p < 0.001). The most frequent adverse event was increased intraocular pressure, reported in 26 patients (37.1%).Discussion Despite less frequent administration than typical aVEGF therapy, dexamethasone implant still leads to clinically meaningful improvements in functional and anatomical outcomes.Conclusion Dexamethasone intravitreal implant was associated with sustained improvements in BCVA in Chinese patients with RVO. Safety outcomes were consistent with previous studies.Clinical Trial Registration Number NCT03908307
Introduction Epikeratophakia is a corneal refractive surgical procedure that has largely been replaced by intraocular lenses and newer refractive surgical techniques. In this procedure, the recipient corneal epithelium is denuded, and a prelathed lamellar donor corneal lenticule is sutured onto the surface of the recipient cornea. The primary pitfall of this technique is the limited predictability of refractive outcomes. The primary advantages include low risk and long-term reversibility. Published cases of successful epikeratophakia lenticule removal with preserved visual acuity are sparse. The long-term reversibility of epikeratophakia and the details of the technique used for successful removal need to be demonstrated. This information could be valuable for future patients and practitioners.Case Presentation The case herein demonstrates the successful removal of an epikeratophakia lenticule that had been in place for 38 years, with minimal damage to the underlying host cornea. The patient regained stable corrected vision of 20/70.Conclusion This case demonstrates the exceptional reversibility of epikeratophakia after 38 years. Successful reversibility of this procedure has been demonstrated up to 14 years, and reversibility with corneal changes has been demonstrated up to 29 years.
Introduction: Obesity is currently the most common form of malnutrition in most regions of the world. Refractive error is a major public health concern worldwide, with astigmatism being the most common type of refractive error. However, it is still unclear whether nutritional status is related to astigmatism in children and adolescents. Methods: A cross-sectional study was performed in 2023, and a stratified cluster sampling technique was employed among school-aged students in Nantong City, China. A total of 9,458 participants were enrolled in the study. Univariate and multivariate logistic regression analyses were carried out to investigate specific correlations between astigmatism and related parameters. Various types of nutritional status were also considered in the study. Results: The prevalence of astigmatism among Chinese school-aged children and adolescents was 28.5%, and the overall prevalence of obesity was 11.8%. Multiple logistic regression analyses showed that nutritional status, refractive state, axis position, and age were significantly associated with astigmatism (all, p < 0.001). Among them, participants with obesity were 2.01 times more likely to suffer from astigmatism (aOR: 2.01, 95% CI: 1.74-2.31, p < 0.001). However, nutritional status was not significantly associated with myopia (p > 0.05). Discussion: Obesity elevates astigmatism risk in children, likely through periorbital fat increasing eyelid pressure on the cornea-supported by the predominance of with-the-rule astigmatism (85.6%). The cross-sectional design limits causal inference, and corneal topography was not analyzed. Public health initiatives targeting childhood obesity may mitigate astigmatism burden, though longitudinal studies are needed to confirm mechanisms. Conclusion: The findings of this study have identified the relationship between nutritional status and astigmatism in children and adolescents. It is necessary to strive to maintain a normal nutritional status in children and adolescents in order to reduce the risk of astigmatism. Clinical Trial Registration No.: ChiCTR2300077367
