PurposeTo propose a novel classification of acute acquired comitant esotropia (AACE) with myopia based on fusion compensation ability at the far point (FP) without myopia correction (MC) and to investigate its pathogenesis in relation to eye-use habits.DesignA retrospective case-control study.MethodsThis study enrolled 105 myopic AACE patients and 107 control subjects with simple myopia. Data collected included refractive error, angle of deviation (measured by prism and alternate cover test (PACT) and Maddox prism test (MPT) at distance and near), and detailed eye-use habits. AACE patients were categorized into compensatory (n = 92) or non-compensatory (n = 13) groups based on their ability to maintain binocular fusion at the FP without MC.ResultsA total of 98.10% of AACE patients neglected MC during prolonged near gaze before onset, a rate significantly higher than controls (13.08%). The cohort was divided into compensatory and non-compensatory groups. The compensatory group (87.62% of patients) exhibited distinct features: larger distance versus near deviation (P < 0.001), greater MPT than PACT at distance (P < 0.001), and near-zero deviation at the FP without MC. In this group, the convergence requirement at the FP (CRFP) showed no significant difference from MPT at distance (MPTD) (P = 0.054) and was positively correlated with both MPTD and PACT at distance (PACTD) (P < 0.05). In contrast, the non-compensatory group (12.38%) had a younger onset age, lower refractive error, larger deviation angles, and worse stereopsis.ConclusionProlonged near gaze without MC is a critical risk factor for myopic AACE. Classifying patients based on fusion compensation at the FP reveals two distinct subtypes with different clinical profiles. The compensatory type likely represents an abnormal adaptation to excessive convergence demand, whereas the non-compensatory type may indicate a decompensated mechanism. This new classification provides valuable insights for etiology and management.

Despite refractive correction and patching, some patients have residual amblyopia. In the current study, we compared the effectiveness of daily 6-hours (6-h) intensive patching and a newly developed individualized and adaptive vision training (iAVT) protocol for residual amblyopia in children. In a randomized clinical trial, 60 children aged 4 to under 11 years with residual amblyopia and visual acuity ranging from 0.2 to 0.8 logarithm of the minimum angle of resolution (logMAR) were assigned to receive either 50 sessions of iAVT training or 6 h of daily patching for 10 weeks. Visual acuity in the amblyopic eye improved more in the iAVT group than in the extended patching group (0.13 versus 0.07 logMAR; 95

AimTo compare the long-term efficiency of botulinum toxin type A (BTXA) injection and surgery on acute acquired comitant esotropia (AACE). MethodsThis retrospective study enrolled patients with AACE from January 2020 to August 2022. The horizontal angle of deviation pre- and post-treatment was measured. Deviations in BTXA and surgical treatment were compared. The BTXA group was divided into adequate treatment (AT) and inadequate treatment (inAT) subgroup based on the deviation of no more than 4 prism diopters (at near and distance) or temporary exotropia at the 2 week follow-up. The two subgroups were compared to determine the long-term efficacy of BTXA treatment. ResultsNinety-two patients with AACE were included. Follow-up was 6 months. The deviations of the surgery and BTXA group were significantly smaller at the 6 month follow-up than at pre-treatment (p < 0.001). The deviation before treatment in the surgery group was larger than in the BTXA groups (p < 0.001) but smaller at the 6 month follow-up (p < 0.001). The deviation was similar in the AT-BTXA and inAT-BTXA subgroups before treatment (p = 0.322 for distance and p = 0.051 for near) but smaller in the AT-BTXA subgroup at 6 month follow-up (p < 0.001 for near and distance). ConclusionSurgery and BTXA successfully treat AACE. Surgery has a more precise and lasting therapeutic effect than BTXA. AACE patients adequately treated with BTXA and with deviations of no more than 4 prism diopters at 2 weeks follow-up had better outcomes.

Objective::To investigate the impact of near vision behavior on myopia progression in schoolchildren.Methods::This was a prospective study. The subjects were recruited from the Eye Hospital, Wenzhou Medical University during 2014-2015. One hundred and twenty-one myopia children (7-12 years) were enrolled and randomized into two groups: single vision lenses group and +2.00 D progressive addition lenses group. Spherical equivalent was measured at baseline and 6-month intervals for 2 years. Near vision behavior parameters were measured with a Polhemus Fastrack system. The right eye data of the subject was taken for statistical analysis. Generalized estimating equation was used to compare the changes in near vision behavior. Pearson correlation test and linear regression were used to analyze the relationship between near vision behavior and myopia progression.Results::There were no significant differences in spherical equivalent and near vision behavior parameters between single vision lenses group and progressive addition group. The baseline reading and writing distances were 31.8±5.8 cm and 25.2±5.8 cm, respectively. Writing distance at baseline were associated with myopia progression -1.54±0.60 D ( r=-0.25, P=0.014). There was a correlation between writing distance of less than 20 cm and myopia progression ( r=-0.52, P=0.011). There was a difference in myopia progression between writing distance less than 20 cm and writing distance greater than 30 cm ( F=3.86, P=0.020). Conclusions::Closer working distance was correlated with greater myopia progression. Appropriate near-vision behavior was one of the essential strategies for myopia prevention and control in children.

Background: The aim of this study was to describe the design, methods, and baseline characteristics of children enrolled in the Personalized Addition lenses Clinical Trial ( PACT). PACT aims to test the myopia control efficacy of progressive addition lenses (PALs) with personalized addition values compared with standard (+ 2.00 D) addition PALs and single vision lenses (SVLs).Methods: PACT is a randomized, controlled, double-masked clinical trial. Two hundred eleven myopic Chinese children (7-12 years) were enrolled and randomized into 1 of the 3 following groups: personalized addition PALs; + 2.00 addition PALs; and SVLs. Personalized addition values were determined based on the highest addition that satisfied Sheard criterion. Axial length and other biometric data were also recorded.Results: At baseline, no differences were found between the right and left eyes for any of the main parameters. The enrolled children were 9.71.1 years ' old with cycloplegic autorefraction (right eye [OD]: +/- 2.36 +/- 0.64 D), near phoria (1.0 +/- 5.0 prism diopter esophoria), lag of accommodation (1.40 +/- 0.50 D) and axial length ( OD: 24.58 +/- 0.74mm). The personalized addition values ranged from + 0.75to + 3.00 ( average +/- SD: 2.19 +/- 0.73 D).Conclusion: PACT is a clinical trial evaluating whether myopia progression in children can be slowed by wearing personalized addition PALs compared with fixed addition PALs and SVLs as measured by cycloplegic autorefraction and axial length. Baseline data were comparable with those of previous myopia control studies in children. Subjects will be followed up every 6 months for 2 years.

Microbial infection is one of the most serious problems in the field of medical devices, particularly in implants. Herein, we have designed and constructed a (mucin/poly(ethyleneimine))(n) ((mucin/PEI)(n)) multilayer film using a layer-by-layer self-assembly method and the grafting of antimicrobial peptides to enhance the bactericidal efficacy. Water contact angle measurements and atomic force microscopy images revealed that the hydrated multilayer film created a highly hydrophilic surface with a low roughness. The functionalized polydimethylsiloxane (PDMS) surfaces were shown to be effective in preventing bovine serum albumin (BSA) adsorption and in reducing bacterial adhesion. Bactericidal activity of the (mucin/PEI)(n)-nisin coatings, measured by scanning electron microscopy and a LIVE/DEAD bacterial viability kit, was remarkably effective against S. aureus owing to the grafting of nisin. In vivo subcutaneous incisions were made in New Zealand white rabbits and were implanted with multilayer-film-modified and uncoated PDMS. Both the evaluation of the appearance of the wound and the histopathology analysis demonstrated that implantation of the antibacterial-coating-modified PDMS promoted wound healing and showed an anti-inflammatory effect. The multilayer film proved to be nontoxic towards human lens epithelial cells, which can potentially be widely used to modify biomedical implants. (C) 2016 Published by Elsevier Ltd.

Infection associated with medical devices is one of the most frequent complications of modern medical biomaterials. Bacteria have a strong ability to attach on solid surfaces, forming colonies and subsequently biofilms. In this work, a novel antibacterial bulk material was prepared through combining poly(dimethyl siloxane) (PDMS) with either hydrophobic or hydrophilic antibiotics (0.1-0.2 wt%). Scanning electron microscopy, water contact angle and UV-vis spectrophotometer were used to measure the changes of surface topography, wettability and optical transmission. For both gentamicin sulfate (GS) and triclosan (TCA), the optical transmission of the PDMS-GS and PDMS-TCA blend films was higher than 90%. Drug release studies showed initial rapid release and later sustained release of GS or TCA under aqueous physiological conditions. The blend films demonstrated excellent bactericidal and sufficient biofilm inhibition functions against Gram-positive bacteria (Staphylococcus aureus, S. aureus) measured by LIVE/DEAD bacterial viability kit staining method. Kirby-Bauer method showed that there was obvious zone of inhibition (7.5-12.5mm). Cytocompatibility assessment against human lens epithelial cells (HLECs) revealed that the PDMS-GS blend films had good cytocompatibility. However, the PDMS-TCA blend films showed certain cytotoxicity against HLECs. The PDMS-0.2 wt% GS blend films were compared to native PDMS in the rabbit subcutaneous S. aureus infection model. The blend films yielded a significantly lower degree of infection than native PDMS at day 7. The achievement of the PDMS-drug bulk materials with high light transmittance, excellent bactericidal function and good cytocompatibility can potentially be widely used as bio-optical materials.

In this study, we report a synthesis of a surface modified heparin-based nanogel using D, L-alpha-lipoic acid. Heparin-PEI-LA nanogel could exist stably in aqueous solution with uniform size distribution. Transmission electron microscopy (TEM) observation showed that the developed heparin-PEI-LA nanogel could adsorb gold nanorods to form AuNRs-nanogel complexes with the aid of a reducing agent such as DTT. Then, the photothermal conversion efficiency and photothermal conversion for killing tumor cell in vitro of these nanogel complexes were detected. The improved cellular killing efficiency of AuNRs-nanogel might be due to an increased cellular uptake of gold nanorods in vitro. Moreover, Cy-7-labelled heparin-PEI-LA nanogel could be enriched in the lungs suggesting the potential use of the nanogel system for targeting the delivery of gold nanorods and a great potential application in the tumor photothermal therapy.

The development of non-cytotoxic hydrogels that can allow for the controlled release of molecules has important clinical and therapeutic applications. In this paper, we developed a series of in situ hydrogels by combining N,O-carboxymethyl chitosan and oxidized alginate without additional crosslinking agents. The rheological properties of these hydrogels as well as their gelling time, swelling ratio, and in vitro degradation behavior were investigated. We observed that although gelation was rapid at physiological temperature, it was even faster in the presence of higher oxidization degree of alginate. In vitro cytotoxicity study showed that the developed hydrogels were not cytotoxic after 24 h of culturing with NIH-3T3 cells. Additionally, bovine serum albumin was released from the hydrogels initially by diffusion at early stages followed by a degradation-dependent mechanism at later stages. In conclusion, the developed hydrogel might have potential application in the drug delivery system and tissue engineering.

In this paper, an in situ injectable nano-composite hydrogel composed of curcumin, N,O-carboxymethyl chitosan and oxidized alginate as a novel wound dressing was successfully developed for the dermal wound repair application. Nano-curcumin with improved stability and similar antioxidant efficiency compared with that of unmodified curcumin was developed by using methoxy poly(ethylene glycol)-b-poly(ɛ-caprolactone) copolymer (MPEG-PCL) as carrier followed by incorporating into the N,O-carboxymethyl chitosan/oxidized alginate hydrogel (CCS-OA hydrogel). In vitro release study revealed that the encapsulated nano-curcumin was slowly released from CCS-OA hydrogel with the diffusion-controllable manner at initial phase followed by the corrosion manner of hydrogel at terminal phase. In vivo wound healing study was performed by injecting hydrogels on rat dorsal wounds. Histological study revealed that application of nano-curcumin/CCS-OA hydrogel could significantly enhance the re-epithelialization of epidermis and collagen deposition in the wound tissue. DNA, protein and hydroxyproline content in wound tissue from each group were measured on 7th day of post wounding and the results also indicated that combined using nano-curcumin and CCS-OA hydrogel could significantly accelerate the process of wound healing. Therefore, all these results suggested that the developed nano-curcumin/CCS-OA hydrogel as a promising wound dressing might have potential application in the wound healing.

Objective To investigate the impact of age and gender on coincidence anticipation timing (CAT).Methods One hundred and sixty-two subjects (74 males,88 females) participated in the CAT study.All subjects were divided into 4 groups by age:younger children,older children,teenagers and adults (7～9,10～12,13～16,and 18～30 years of age,respectively).Speed trac was used to measure CAT.Ten unrecorded trials were presented for familiarization,and then 30 trials were record under the coincidence anticipation timing format.Constant error (CE),absolute error (AE) and variable error (VE) were calculated to evaluate CAT.Results Responses (5.03±4.14)ms were delayed in younger children compared to the faster responses of the other groups (F =3.459,P 0.05).The AE differed significantly between younger children and the other groups (P0.05).A significant difference was also found between older children and the other groups (P0.05).Coincidence timing accuracy improved with increased age.The VE differed significantly between groups except between teenagers and adults.Variability decreased with an increase in age.For all subjects,the AE and CE did not differ significantly between males and females (P 0.05).However,when gender differences were compared for each age group,the AE and CE between adult males and females were significantly different (P 0.01),males females.Conclusion The accuracy and response variability of coincidence anticipation timing increase with an increase of age,with men performing better than women.