Introduction Small pupils complicate cataract surgery and increase intraoperative risk. The Malyugin ring is a widely used mechanical pupil-expansion device lacking a comprehensive evidence synthesis. This review evaluated its efficacy and safety in adults. Methods A total of 4 databases (EMBASE, MEDLINE, CINAHL Plus, Web of Science) were searched from inception to October 21, 2024, with an updated search conducted on June 28, 2025. Randomized and observational studies involving adults undergoing cataract surgery with a Malyugin ring were eligible. The outcomes included dilation adequacy, surgical duration, intraoperative complications, endothelial cell loss, and visual acuity. Risk of bias was assessed using RoB 2 and ROBINS-I, and the certainty of evidence was evaluated using GRADE. A narrative synthesis was performed in accordance with PRISMA guidelines (PROSPERO CRD420251069562). Results Altogether 10 studies (3,233 eyes) were included. The Malyugin ring provided stable dilation (5.5–7.0 mm) in small pupils and in patients with pseudoexfoliation syndrome. Relative to iris hooks and manual stretching, it was associated with shorter phacoemulsification time (15.2 vs . 19.8 s) and lower endothelial cell loss (9.35% vs . 13.77%). The visual outcomes were favorable, although some studies reported higher rates of iris tears and pupil ovalization compared with those observed with comparator techniques. Discussion These findings suggest advantages in surgical efficiency and early visual recovery. However, the evidence comprises 2 randomized and 8 non-randomized studies with risk of bias ranging from low to serious, and no outcomes could be pooled; therefore, comparative conclusions remain tentative. Conclusion The Malyugin ring appears effective and generally safe in adult cataract surgery; reported complications were typically not visually significant. Certainty of evidence was low to very low (GRADE), and superiority over alternative devices is not established.
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.
IntroductionDry 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. MethodsThis 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. ResultsThe 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. DiscussionThis 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. ConclusionThis study shows that patients with DR-DED had a significantly greater ocular tear health burden than those with DR-only, 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.
