Purpose:To evaluate the efficacy and safety of Rose Bengal (RB) and green light crosslinking (RGX) with supplemental oxygen. Methods:Rabbits were divided into three groups. Rabbits in the control group were de-epithelialized and served as controls. Rabbits in the RGX-nO2 group were de-epithelialized, stained with 0.1% RB for 20 minutes, and then exposed to green light at 0.25 W/cm2 for 10 minutes in an ambient atmospheric oxygen environment. Rabbits in the RGX-hO2 group received the same treatment as group 2, but supplemental oxygen was given to the ocular surface during irradiation. Central corneal thickness was measured at various points during RGX. After RGX, corneal microstructure, corneal biomechanics, and resistance to enzyme lysis were evaluated. Results:RGX-hO2 and RGX-nO2 significantly increased the corneal tensile strength by factors of 1.76 and 1.46, respectively. The times for complete corneal digestion within the RGX-hO2, RGX-nO2, and control groups were 23.2 ± 1.1 hours, 18.0 ± 2.0 hours, and 8.4± 0.9 hours. The average collagen fibril diameters (43.58 ± 0.93 nm, 40.46 ± 1.11 nm, and 35.25 ± 0.75 nm, respectively) and surface-to-surface spacing (11.67 ± 1.91 nm, 15.51 ± 1.66 nm, and 24.93 ± 1.95 nm, respectively) also differed statistically among the three groups. No evidence of endothelial or stromal cell damage was detected by endothelial staining or TUNEL assay. Conclusions:Increasing the concentration of oxygen during the irradiation process enhances RGX efficacy without causing obvious damage to a rabbit's endothelium or stromal cells. Translational Relevance:The study can potentially help with improvement of the existing clinical crosslinking protocol.

To investigate whether in diabetic cataract (DC), FoxO1 regulates high glucose (HG)-induced activation of NLRC4/IL-6 inflammatory mediators in human lens epithelial cells (SRA01/04) via the JAK1/STAT1 pathway, leading to cataract formation. Expression levels of FoxO1, inflammatory factor IL-6 and inflammatory vesicle NLRC4 were examined in SRA01/04 under high glucose (HG) stress at 25–150 mM. Rat lenses were also cultured using HG medium with or without the addition of the FoxO1 inhibitor AS1842856 and the JAK1 agonist RO8191. 5.5 mM glucose concentration group (NG) was used as a control. Real-time PCR, Western blots, and immunofluorescent staining evaluated the mRNA and protein levels of FoxO1, NLRC4, and IL-6. Apoptosis, cell viability, and EDU Staining were also assessed. HG stimulation induced elevated FoxO1 expression and caused NLRC4/IL-6 activation in a concentration-dependent manner. Whereas knockdown of FoxO1 inhibited the high expression of NLRC4/IL-6 inflammatory mediators in response to HG stimulation. The growth of SRA01/04 was inhibited under HG condition, and the cell proliferation ability was restored and even promoted by knocking out FoxO1. HG incubation of rat lens resulted in lens clouding and cataract formation, which was prevented by AS1842856 treatment and reversed by RO8191. FoxO1 positively regulates HG-induced SRA01/04 inflammatory activation through the JAK1/STAT1 pathway and promotes DC. This provides a feasible strategy for the treatment of diabetic cataract.

Abstract Background To assess the safety and efficacy of phakic refractive lens (PRL) implantation for correcting high myopia, as well as an ophthalmic viscosurgical device-free (OVD-free) method for PRL implantation. Methods In this real-world prospective study, consecutive patients implanted with PRL in one or both eyes were enrolled. Based on the surgical techniques used, the eyes were divided into the OVD-free method group and the conventional method group. The patients were examined 2 h after surgery and were scheduled for follow-up at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months. The corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), the manifest refraction spherical equivalent (MRSE), intraocular pressure (IOP) and lens vault were assessed postoperatively. Corneal endothelial cell density (ECD) was measured at the 3- and 12-month postoperative visits. Results Fifty-seven consecutive patients (108 eyes) were enrolled. At the 3-month postoperative visit, both mean UDVA and CDVA were significantly improved after PRL implantation (0.19 ± 0.21 and 0.01 ± 0.14 logMAR) with efficacy index and safety index of 0.92 and 1.30, respectively. None of the eyes had any loss of CDVA. The percentage of eyes within ± 0.50 D and ± 1.00 D of target refraction was 58% and 83%, respectively. Mean MRSE changed from − 14.49 ± 4.22 D, preoperatively, to − 1.22 ± 1.26 D at 1 day (P < 0.001) and remained stable thereafter. Mean endothelial cell loss was 11.3%, 9.6%, respectively, at 3 and 12 months, with no significant difference between the two follow-ups (P = 0.395). Fifty-nine eyes received the OVD-free method, and 49 eyes received the conventional method. The OVD-free method demonstrated a significant reduction in the incidence of early acute IOP elevations (28.8% vs. 53.1%, P = 0.022) compared to the conventional method. The difference of initial endothelial cell loss (9.4 ± 14.2% vs. 13.6 ± 14.6%) between the two groups trended toward significance (P = 0.056). In both groups, no other major complications were observed up to 12-month follow-up. Conclusions PRL implantation was a safe, efficient, predictable and stable method for correcting high myopia. The potential of lower incidence of early acute IOP elevations makes the OVD-free method a promising alternative to the conventional method. Trail registration: Chinese Clinical Trial Registry, ChiCTR2100043600. Registered on 23 February 2021, https://www.chictr.org.cn/showproj.html?proj=122229

PURPOSE: To investigate the repeatability and agreement of corneal astigmatism measurements in eyes with irregular corneal astigmatism component (ICAC) using four devices: IOLMaster 700 biometer, Lenstar 900 biometer, iTrace, and Pentacam. DESIGN: Prospective cross-sectional reliability analysis. METHODS: Sixty-four eyes (52 patients) with ICAC were examined three times using the four devices. The eye with ICAC in this study is defined as the cornea has a certain degree of irregular astigmatism (asymmetric and/or skewed bowtie pattern of corneal topography according to corneal topography classification), accompanied with total corneal higher-order aberrations in the 4 mm zone of 0.3 mu m or greater. Corneal astigmatism was evaluated using three categories: anterior corneal astigmatism (ACA), posterior corneal astigmatism, and total corneal astigmatism (TCA). The repeatability was determined using the Delta Ast (arithmetic mean of vector differences among three repeated corneal astigmatism measurements). Bland-Altman plots and astigmatism vector analyses were employed to assess agreement. RESULTS: The IOLMaster 700 ( Delta Ast = 0.27 +/- 0.20 D) showcased higher repeatability in ACA measurements compared to iTrace ( Delta Ast = 0.37 +/- 0.38 D, P = .040) and Pentacam ( Delta Ast = 0.50 +/- 0.22 D, P < .001), and paralleled the performance of Lenstar 900 ( Delta Ast = 0.31 +/- 0.26 D, P = .338). The Pentacam ( Delta Ast = 0.09 +/- 0.07 D, P < .001) demonstrated superior repeatability in posterior corneal astigmatism, whereas the IOLMaster 700 ( Delta Ast = 0.33 +/- 0.23 D, P < .001) excelled in TCA. The IOLMaster 700 exhibited good agreement with either Lenstar 900 or iTrace, characterized by narrow 95% limits of agreement and clinically acceptable vector differences. Conversely, vector differences between Pentacam and the other three devices in ACA and TCA measurements were clinically significant, exceeding 0.50 D (all P < .05). CONCLUSIONS: In terms of repeatability of corneal astigmatism measurements in eyes with ICAC, the IOLMaster 700 and Lenstar 900 outperformed iTrace and Pentacam. While the IOLMaster 700 can be used interchangeably with either Lenstar 900 or iTrace, the Pentacam is not interchangeable with the other three devices.

Background: Cataracts are still the main cause of blindness worldwide. The incidence of cataracts in the diabetic population is 3-5 times higher than in healthy people. With the increasing incidence of diabetes and the development of aging, as well as the higher risk of surgical and postoperative complications of diabetic patients undergoing surgery, it is still necessary to study the occurrence and development mechanism of diabetic cataracts as well as potential therapeutic targets and therapeutic drugs.Methods: A retrospective review of the literature from PubMed (2017-2024).Results: We summarized the the current literature on the molecular mechanism and prevention and treatment of diabetic cataracts.Conclusions: The aqueous humor metabolism changes, oxidative stress, reactive oxygen species generation increase, the conversion of polyol pathway, as well as non-coding RNA expression changes play important roles in diabetic cataract and these processes is closely linked with each other. Inhibitors or drugs target to these processes, such as aldose reductase inhibitors, antioxidants, natural flavonoid compounds, as well as nanotechnology-based therapeutic product, have shown promising prospects in the prevention and treatment of diabetic cataract.

AIM: To investigate the molecular diagnosis of a three-generation Chinese family affected with aniridia, and further to identify clinically a PAX6 missense mutation in members with atypical aniridia. METHODS: Eleven family members with and without atypical aniridia were recruited. All family members underwent comprehensive ophthalmic examinations. A combination of whole exome sequencing (WES) and direct Sanger sequencing were performed to uncover the causative mutation. RESULTS: Among the 11 family members, 8 were clinically diagnosed with congenital aniridia (atypical aniridia phenotype). A rare heterozygous mutation c.622C>T (p.Arg208Trp) in exon 8 of PAX6 was identified in all affected family members but not in the unaffected members or in healthy control subjects. CONCLUSION: A rare missense mutation in the PAX6 gene is found in members of a three-generation Chinese family with congenital atypical aniridia. This result contributes to an increase in the phenotypic spectrum caused by PAX6 missense heterozygous variants and provides useful information for the clinical diagnosis of atypical aniridia, which may also contribute to genetic counselling and family planning.

Purpose: To evaluate the repeatability and agreement of two swept-source optical coherence tomographers and Scheimpflug imaging for corneal curvature in healthy subjects. Methods: Simulated keratometry (SimK), posterior keratometry (Kp), total corneal power (TCP), and total corneal astigmatism(TCA) were measured with CASIA2, Anterion, and Pentacam. Within-subject standard deviation (Sw), repeatability coefficient (RC), coefficient of variation (CoV), and intraclass correlation coefficient (ICC) were used to assess inter-device repeatability. Bland-Altman analysis was performed to determine inter-device agreement. Results: Three devices showed good repeatability for SimK, Kp, and TCP with all the ICC > 0.980. Pentacam showed the highest repeatability while the CASIA2 revealed the lowest repeatability for SimK and TCP. Anterion and CASIA2 revealed better repeatability for Kp than Pentacam. Pentacam and Anterion showed good repeatability for TCA, whereas the CASIA2 showed moderate repeatability. Three instruments demonstrated good agreement with the maximum absolute 95% Limits of agreement (LoA) of 1.00 D for SimK, Kp, and TCP. Wide LoA were found between for TCA with the maximum absolute 95% LoA ≥0.66 D between the three devices. Conclusions: Three devices illustrated good repeatability for SimK, Kp, and TCP. Both Anterion and Pentacam showed good repeatability for TCA while CASIA2 displayed moderate repeatability. Good agreement was found for SimK, Kp, and TCP but not for TCA.

PURPOSE: To assess the influence of ocular biometric parameters on intraocular lens (IOL) tilt and decentration after cataract surgery. METHODS: Patients scheduled for cataract surgery were screened for inclusion in this prospective cohort study. Tilt and decentration of the crystalline lens and IOL were measured using the CASIA2 (Tomey). Anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were preoperatively measured by the IOLMaster 700 (Carl Zeiss Meditec AG). Multivariate regression analysis was performed to assess the influence of ocular biometric parameters on IOL tilt and decentration after cataract surgery. RESULTS: In total, 191 eyes of 120 patients were included. Age was positively correlated with IOL tilt, whereas ACD and AL were negatively correlated with IOL tilt. A strong positive correlation was found between preoperative crystalline lenses and postoperative IOLs in tilt magnitude ( r = 0.769, P < .001) and tilt direction ( r = 0.688, P < .001). A positive correlation was found between preoperative and postoperative lens decentration magnitude and decentration direction. Greater postoperative IOL tilt and decentration were significantly associated with greater preoperative crystalline lens tilt ( P < .001) and decentration ( P = .027). CONCLUSIONS: IOL tilt was greater in older patients. Shorter AL and shallower ACD contributed to greater IOL tilt. The tilt and decentration of the IOL will be greater in patients with greater tilt and decentration of the crystalline lens.

Purpose: To investigate the feasibility and efficacy of a continuous functional contrast visual acuity (CFCVA) system in the assessment of visual function in dry eye disease (DED). Methods: Twenty patients with DED and 15 normal controls were recruited. Subjective symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, and tear film stability was assessed by a noninvasive corneal topographer. Under natural blinking conditions, the custom-built CFCVA system was used to take serial visual acuity measurements at 100%, 25%, 10%, and 5% contrast for 60 seconds. A 5-minute measurement at a 100% contrast level was defined as the stress test (ST). Mean CFCVA was defined, and visual maintenance ratio (VMR) was the ratio of mean CFCVA divided by baseline visual acuity. Results: In both groups, VMR decreased and mean CFCVA (logarithm of the minimum angle of resolution) increased with decreasing optotype contrast (from 100% to 5%). In ST, the ST VMR at the fourth and fifth minutes (VMR54 and VMR55) showed the strongest correlations with OSDI total, ocular symptoms, and vision-related function (−0.646 and −0.598, −0.688 and −0.693, and −0.599 and −0.555, respectively, P < 0.05). VMR54 and VMR55 also demonstrated the best discriminating ability for detecting DED, with areas under the curve of 0.903 and 0.867, respectively. Conclusions: Extending the continuous measuring time was more effective for detecting vision-related functional abnormalities in patients with DED than simply decreasing the optotype contrast level. Translational Relevance: The proposed CFCVA system and associated parameters offer a potential method for quantifying and interpreting the visual symptoms of DED in clinical care.

AbstractBackgroundTo assess the effect of tear film instability in dry eye disease (DED) by measuring visual performance and tear film optical quality in a simultaneous real-time analysis system.MethodsThirty-seven DED participants and 20 normal controls were recruited. A simultaneous real-time analysis system was developed by adding a functional visual acuity (FVA) channel to a double-pass system. Repeated measurements of FVA and objective scatter index (OSI) were performed simultaneously with this system under blink suppression condition for 20 s. Patient-reported symptoms was evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Mean FVA, mean OSI, and visual acuity break-up time were defined. The OSI maintenance ratio was calculated as an evaluation index to assess the difference between dynamic OSI changes and baseline OSI. The visual maintenance ratio was also calculated in the same way.ResultsModerate correlations were noted between mean OSI and FVA-related parameters (mean FVA, visual maintenance ratio, visual acuity break-up time: 0.53, − 0.56, − 0.53, respectively,P < 0.01 for all). Moderate to high correlations were noted between OSI maintenance ratio and FVA-related parameters (mean FVA, visual maintenance ratio, visual acuity break-up time: − 0.62, 0.71, 0.64, respectively, allP < 0.01). The metrics derived from the simultaneous real-time analysis system were moderately correlated with the patient-reported symptoms and the visual acuity break-up time possessed the highest correlation coefficients with OSDI total, ocular symptoms, and vision-related function (− 0.64, − 0.63, − 0.62, respectively,P < 0.01). The OSI-maintenance ratio alone appeared to exhibit the best performance of the metrics for the detection of DED with sensitivity of 95.0% and specificity of 83.8% and the combinations of FVA parameters and OSI parameters were valid and can further improve the discriminating abilities.ConclusionsOSI-related metrics were found to be potential indicators for assessing and diagnosing DED which correlated with both subjective visual performance and patient-reported symptoms; the FVA-related metrics were quantifiable indicators for evaluating visual acuity decline in DED.Trial registration number:Chinese Clinical Trial Registry, ChiCTR2100051650. Registered 29 September 2021,https://www.chictr.org.cn/showproj.aspx?proj=134612

Introduction Blepharophimosis, ptosis, and epicanthus inversus syndrome (BPES) is a rare genetic disease with diverse ocular malformations. This study aimed to investigate the disease-causing gene in members of a BPES pedigree presenting with the rare features of anisometropia, unilateral pathologic myopia (PM), and congenital cataracts. Methods The related BPES patients underwent a comprehensive ocular examination. Next, whole-exome sequencing (WES) was performed to screen for the disease-causing genetic variants. A step-wise variant filtering was performed to select candidate variants combined with the annotation of the variant's pathogenicity, which was assessed using several bioinformatic approaches. Co-segregation analysis and Sanger sequencing were then conducted to validate the candidate variant. Results The variant c.672_701dup in FOXL2 was identified to be the disease-causing variant in this rare BPES family. Combined with clinical manifestations, the two affected individuals were diagnosed with type II BPES. Conclusion This study uncovered the variant c.672_701dup in FOXL2 as a disease causal variant in a rare-presenting BPES family with anisometropia, unilateral pathogenic myopia, and/or congenital cataracts, thus expanding the phenotypic spectrum of FOXL2 .

To compare the safety and efficacy of femtosecond laser-assisted cataract surgery (FLACS) performed with the low-energy FEMTO LDV Z8 (Ziemer Ophthalmic Systems AG, Port, Switzerland) laser compared with conventional phacoemulsification (CP) in Chinese patients. This prospective, multicenter, interventional study included 126 patients who were randomized (1:1) to undergo either FLACS or CP followed by intraocular lens (IOL) implantation between January 2019 and April 2020. The primary endpoint included the comparison of the endothelial cell loss (ECL) between the two groups at 3 months. Secondary endpoints included the comparison of cumulative dissipated energy (CDE), change in central corneal thickness (CCT) from baseline, and postoperative uncorrected and corrected distance visual acuities (UDVA and CDVA) in the two groups. At all postoperative time points, the FLACS group was found to be non-inferior to CP for the mean ECL (− 409.3 versus − 436.9 cells/mm2 at 3 months) and mean CDE (4.1 versus 4.5 percent-seconds). The increase in CCT was significantly lower in the FLACS group compared with the CP group at Day 7 (4.9 versus 9.2 µm; P = 0.04); however, the difference was not statistically significant at 1 and 3 months. Postoperatively, mean UDVA and CDVA were comparable between the two groups. No intraoperative complications occurred. Cataract surgery performed with a low-energy femtosecond laser was non-inferior to CP; however, the FLACS group had a statistically significantly lower increase in CCT at Day 7 compared with CP. Trial registration This trial is registered at ClinicalTrials.gov on May 15, 2019, with trial registration number: NCT03953053.

purpose: Maternally Inherited Leigh Syndrome (MILS) is a group of systemic diseases caused by defects in mitochondrial oxidative phosphorylation (OXPHOS). We aim to investigate the clinical and genetic characteristics of MILSpedigree with MT-ATP6 mutation who were first diagnosed with RP. Methods: This study included a family pedigree consisting of a proband with visual blurring symptoms, his mother with similar symptoms, and a father who was asymptomatic. The medical history was asked, and the best corrected visual acuity (BCVA), intraocular pressure, slit-lamp, wide-field fundus photography, optical coherence tomography (OCT), visual evoked potential (VEP) and whole exome sequencing were performed. In addition, brain Magnetic Resonance Imaging (MRI) and physical examination were performed for the mother and child. Results: Whole exon sequencing showed that the proband carried mitochondrial MT-ATP6 gene mutation. The proband's mother carried an 8993T>G heterozygous mutation, with a heterozygous mutation load of 86%, which was inherited from the proband's mother (heterozygous mutation load of 62%). This gene is the primary pathogenic gene of MILS. The patient was diagnosed with MILS after a complete physical examination and imaging examination. Conclusions: This study suggests that RP can be the cause of the first visit of MILS patients. Therefore, ophthalmologists should be alert to MILS when they find patients with clinical symptoms of the nervous system in the face of RP patients. MT-ATP6 mutation is one of the causes of RP, and its pathogenic mechanism has not been clearly explained. In the future, the research and intervention of MT-ATP6 mutation may provide a new direction for the diagnosis and treatment of MILS-related RP.

PURPOSE:To investigate refractive prediction accuracy with the OA-2000 (Tomey), Anterion (Heidelberg Engineering), and IOLMaster 500 (Carl Zeiss Meditec AG) in patients with cataract. METHODS:Patients with cataract referred for phacoemulsification were enrolled and scanned with the OA-2000, Anterion, and IOLMaster 500 in random order. The success rate of axial length (AL) measurements per device was calculated and a chi-square test was used to identify the differences in acquisition rate between the three devices. The Bland-Altman method was used to appraise the agreement of biometric parameters between the three devices. Four different formulas (Barrett Universal II [BUII], Haigis, Holladay 1, and SRK/T) were included in the study. The parameters of refractive prediction accuracy comprised predictive error (PE), absolute PE (AE), and percentages of eyes with a PE within ±0.50, ±0.75, and ±1.00 diopters (D). RESULTS:The acquisition rates of AL measurements with the OA-2000 and Anterion were 97.35% and 94.70%, respectively (chi-square = 3.82, P > .05). A significantly lower acquisition rate of 84.82% was obtained with the IOLMaster 500 compared with the other two devices (P < .05). Bland-Altman analysis identified good agreement between the three biometers with narrow 95% limits of agreement for flat and steep keratometry (K1 and K2), anterior chamber depth (ACD), and AL. For PE, only the differences between the Anterion and IOLMaster 500 with the Barrett UII and Haigis formulas were statistically significant (P < .05). The three devices revealed no statistically significant differences in MAE, MedAE, and the proportion of eyes with a PE within ±0.50, ±0.75, and ±1.00 D (P > .05). CONCLUSIONS:The OA-2000 and Anterion showed a similarly higher acquisition rate of AL measurements than the IOLMaster 500 in patients with cataract. Good agreement for K1, K2, ACD, and AL was found between the three biometers. Regarding refractive prediction accuracy, the Anterion did not significantly outperform both the OA-2000 and IOLMaster 500. [J Refract Surg. 2023;39(1):48-55.].

Background Congenital cataract-microcornea syndrome (CCMC) is characterized by the association of congenital cataract and microcornea without any other systemic anomaly or dysmorphism. Although several causative genes have been reported in patients with CCMC, the genetic etiology of CCMC is yet to be clearly understood. Purpose To unravel the genetic cause of autosomal dominant family with CCMC. Methods All patients and available family members underwent a comprehensive ophthalmologic clinical examination in the hospital by expert ophthalmologists and carried out to clinically diagnosis. All the patients were screened by whole-exome sequencing and then validated using co-segregation by Sanger sequencing. Results Four CCMC patients from a Chinese family and five unaffected family members were enrolled in this study. Using whole-exome sequencing, a missense mutation c.295G > T (p.A99S, NM_003106.4) in the SOX2 gene was identified and validated by segregation analysis. In addition, this missense mutation was predicted to be damaging by multiple predictive tools. Variant p.Ala99Ser was located in a conservation high mobility group (HMG)-box domain in SOX2 protein, with a potential pathogenic impact of p.Ala99Ser on protein level. Conclusions A novel missense mutation (c.295G > T, p.Ala99Ser) in the SOX2 gene was found in this Han Chinese family with congenital cataract and microcornea. Our study determined that mutations in SOX2 were associated with CCMC, warranting further investigations on the pathogenesis of this disorder. This result expands the mutation spectrum of SOX2 and provides useful information to study the molecular pathogenesis of CCMC.

Purpose: To explore whether there is a causal relationship between coffee consumption and primary open-angle glaucoma (POAG). Design: Two-sample Mendelian randomization (MR). Participants: The single-nucleotide polymorphisms (SNPs) associated with coffee consumption (including phenotypes 1 and 2) were selected from a genome-wide association study (GWAS) involving 121 824 individuals of European descent. Coffee intake from the MRC-IEU UK Biobank was also used to identify instruments for coffee intake. Summary-level data for POAG were obtained from the largest publicly available meta-analyses involving 16 677 POAG cases and 199 580 controls of European descent. Methods: The inverse variance-weighted (IVW) method was the main MR analysis, whereas weighted-median, weighted mode-based estimate (MBE), MR Pleiotropy RESidual Sum and Outlier (PRESSO) test, and MR-Egger regression were used for sensitivity analysis. Main Outcome Measures: Diagnosis of POAG. Results: Three sets of instrumental variables were used to evaluate the causal association between coffee consumption and POAG risk. Results showed that genetically predicted higher coffee consumption phenotype 1 (cups/day) was significantly associated with higher risk of POAG (odds ratio [OR], 1.241; 95% confidence interval [CI], 1.041-1.480; P = 0.016). Genetically predicted higher coffee consumption phenotype 2 (high vs. no/low) was also significantly associated with higher risk of POAG (OR, 1.155; 95% CI, 1.038-1.284; P = 0.008, using the IVW method). Moreover, genetically predicted higher coffee intake from the MRC-IEU UK Biobank OpenGWAS was significantly associated with a higher risk of POAG (OR, 1.727; 95% CI, 1.230-2.425; P = 0.002, using the IVW method). Sensitivity analyses confirmed that the findings were robust to possible pleiotropy. Conclusions: These findings provide the genetic evidence that higher coffee consumption is associated with a higher risk of POAG. Given that coffee is widely consumed, our findings provide new insights into potential strategies to prevent and manage POAG. (c) 2022 by the American Academy of Ophthalmology

目的 评价维视安? CTR型囊袋张力环植入术后5年及以上的安全性和有效性.设计 前瞻性队列研究.研究对象 36例受试者完成5年以上延续观察,试验组和对照组各18例.临床研究机构为中山大学中山眼科中心、陆军军医大学陆军特色医学中心眼科(大坪医院)、温州医科大学附属眼视光医院3家医院.方法 对前期实施晶状体摘除联合囊袋张力环及IOL植入术并完成术后1年随访的受试者(单眼入组)进行5年以上的延续观察.前期已将受试者随机分为两组,试验组植入维视安? CTR型囊袋张力环,对照组植入TENSIOBAG型囊袋张力环.主要指标裸眼远视力(LogMAR)、最佳矫正远视力(LogMAR)、屈光度、眼压、角膜内皮细胞密度、裂隙灯检查结果、视觉不良症状主观评价结果、远视脱镜率及总体满意度.结果 基线时,两组受试者基本资料、眼科专科检查等方面的差异均无统计学意义.术后不同访视时间点,裸眼远视力、最佳矫正远视力、客观屈光度测量值两组组间比较均无统计学差异(P均＞0.05).术后5年及以上时,裸眼远视力:试验组由术前0.49±0.41改善至0.20±0.20,对照组由术前0.52±0.51改善至0.32±0.33;试验组裸眼远视力达到0.30及更佳的比例为88.89％,对照组为72.22％;最佳矫正远视力:试验组由术前0.44±0.37改善至0.09±0.12,对照组由术前0.34±0.23改善至0.10±0.21;屈光度:试验组由术前(-3.52±8.70)D改善至(-0.70±2.05)D,对照组由术前(-4.49±7.14)D改善至(-0.51±1.32)D.试验组视力和屈光度与其他术后时间点比较均无显著差异,而对照组出现一定程度波动;两组眼压比较无显著性差异(P均＞0.05),与基线期比较均无显著性差异(P均＞0.05);两组角膜内皮细胞密度比较无显著性差异(P--0.128).两组受试者均未出现IOL偏移、囊袋位置异常及皱缩的情况;裂隙灯检查、视觉不良症状主观评价、脱镜情况和总体满意度两组组间比较均无统计学差异(P均＞0.05).结论 通过对维视安? CTR型张力环植入术后5年及以上的小样本量研究发现,受试者术后远期视力和屈光度均较为平稳,眼压及角膜内皮细胞密度正常,受试者主诉无明显视觉不良症状,总体满意度较高,远期的安全性和有效性良好.

To investigate the repeatability of Anterion and compare the agreement of ocular biometric measurements and predicted intraocular lens (IOL) powers with other three optical biometers. Flat keratometry (Kf), steep keratometry (Ks), J0 and 45 vectors, central cornea thickness (CCT), anterior chamber depth (ACD), and axial length (AL) from the Anterion, IOLMaster 700, Lenstar LS 900, and OA-2000 were recorded. The IOL powers were calculated with the Hoffer Q, Holladay 1, SRK/T, and Haigis formulas. The repeatability was evaluated using the within-subject standard deviation (Sw), repeatability coefficient (RC), coefficient of variation (COV), and intraclass correlation coefficient (ICC). Inter-device agreement between the four biometers was assessed with the 95% limits of agreement. In total, 101 right eyes of 101 participants were enrolled. The Anterion showed good repeatability for all the included biometric parameters with all the CoV ≤ 0.30% and ICC ≥ 0.930 except for J45 with moderate repeatability (ICC was 0.849). Good agreement was found among the four devices for Kf, Ks, J0, J45, ACD, and AL. Generally, wide 95% LoA was found for the predicted IOL powers with the four IOL calculation formulas between the four devices. The Anterion showed good repeatability of biometric measurements for most parameters. Good agreement among the four optical biometers was achieved for all the parameters except for CCT and the predicted IOL power. The AL values exhibited the best repeatability with Anterion and the best agreement among the biometers in our study.

Objective::To detect the main problems in the formation of ethics committees in eye hospitals in China and to provide relevant solutions for them by investigating the current status and understanding the establishment and operation at these hospitals.Methods::This was a cross-sectional study. Convenience sampling combined with online distribution was adopted to investigate 33 ethics committees in eye hospitals all over the country from October 2018 to October 2019. The contents included the profile, formation, and operation of these ethics committees. Valid questionnaire data were selected and analyzed using descriptive statistical analysis.Results::A total of 21(64%) eye hospitals had established ethics committees, and the other 12(36%) had not. Of the 21 hospitals with ethics committees, 12 hospitals had independent ethics committees, 9 hospitals had full-time secretaries or staff, 4 hospitals did not have outside committee members, 7 hospitals had not established the presiding censorship, 4 hospitals had not conducted annual or regular follow-up reviews, and 3 hospitals had not organized ethics-related training for their researchers.Conclusions::There are problems in ethics committees in eye hospitals, such as chaotic subordinate relationships, inappropriate membership, inadequate training of committee members, and a lack of the whole course of ethics censorship. Specialized eye hospitals still need to strengthen the establishment of ethics committee setup, personnel composition, effective guaranteed conditions, effective training mechanisms, and normalized ethical review procedures. Mean while, it is recommended to establish a collaborative ethics censor alliance in eye hospitals, to actively promote a more normalized formation of ethics committees in the alliance, and to revise and improve standard operating procedures. While increasing the efficiency of ethical reviews, there are benefits in promoting the development, normalization and high quality of these ethics committees in eye hospitals.