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Journal of Cataract and Refractive... Jun 2024To assess corneal sensitivity and the ocular surface in patients undergoing primary femtosecond laser in situ keratomileusis (FS-LASIK) and those undergoing FS-LASIK...
PURPOSE
To assess corneal sensitivity and the ocular surface in patients undergoing primary femtosecond laser in situ keratomileusis (FS-LASIK) and those undergoing FS-LASIK retreatment under the same flap due to residual refractive error.
SETTING
Ekol Eye Hospital, Izmir, Turkey.
DESIGN
Prospective case series.
METHODS
Nineteen patients with previous FS-LASIK who had myopic and astigmatic refractive error were included in the study group, and 19 age- and sex-matched patients undergoing FS-LASIK for the first time as the control group. Corneal sensitivity, Schirmer test, tear film break-up time (TBUT), Oxford grading scheme for ocular surface staining, and Ocular Surface Disease Index (OSDI) were measured preoperatively and at postoperative 1 week and 1, 3, and 6 months.
RESULTS
The mean refractive correction in the study and control groups respectively was 2.18±0.78 D (range: 1.00-3.50) and 2.76±1.20 D (range: 1.00-4.50; p=0.07). Corneal esthesiometry results in the study and control groups respectively were 6.10±12.55 vs. 9.90±11.50 mm at 1 week (p=0.001), 41.95±6.98 vs. 45.09±5.88 mm at 1 month (p=0.004), 56.09±3.37 vs. 56.19±2.52 mm at 3 months (p=0.8), and 58.60±2.01 vs. 58.80±1.39 mm at 6 months (p=0.5). Significant difference between the two groups in Schirmer test score that disappeared at postoperative 3 months and in TBUT and ocular surface staining that disappeared at 6 months, whereas the statistically significant difference in OSDI score persisted at 6 months (p=0.03) was detected.
CONCLUSION
Corneal surface sensitivity and ocular surface health are more impaired in patients undergoing FS-LASIK retreatment due to residual refractive error.
PubMed: 38940469
DOI: 10.1097/j.jcrs.0000000000001511 -
Journal of Cataract and Refractive... Jun 2024To evaluate prediction accuracy of formulas included in the ESCRS-Online-IOL-Calculator using standard keratometry (K) or total keratometry (TK).
PURPOSE
To evaluate prediction accuracy of formulas included in the ESCRS-Online-IOL-Calculator using standard keratometry (K) or total keratometry (TK).
SETTING
Hospital-based academic practice.
DESIGN
Retrospective case-series.
METHODS
Participants: 523 cataract patients (523 eyes). Outcome Measures: trimmed-means of the spherical equivalent prediction error (SEQ-PE, trueness), precision and absolute SEQ-PE (accuracy) of all seven formulas available on the ESCRS-Online-IOL-Calculator as well as the mean (Mean-All) and median (Median-All) of the predicted SEQ refraction of all formulas. Sub-group analyses evaluated the effect of axial length on formula accuracy.
RESULTS
Trimmed-mean SEQ-PE range of all formulas varied from -0.075 to +0.071D for K-based and from -0.003 to +0.147D for TK-based calculations, with TK-based being more hyperopic in all formulas (p<0.001). Precision ranged from 0.210 to 0.244D for both K-based and TK-based calculations. Absolute SEQ-PE ranged from 0.211 to 0.239D for K-based and from 0.218 to 0.255D for TK-based calculations. All formulas, including Mean-All and Median-All, showed high accuracy with 84-90% of eyes having SEQ-PEs within 0.50D.Myopic trimmed-mean SEQ-PEs significantly different from zero were observed in long eyes for Pearl DGS (-0.110D, p=0.005), Hill RBF (-0.120D, p<0.001) and Hoffer QST (-0.143D, p=0.001), and in short eyes for EVO 2.0 (-0.252D, p=0.001), Kane (-0.264D, p=0.001), Hoffer QST (-0.302D, p<0.001), Mean-All (-0.122D, p=0.038) and Median-All (-0.125D, p=0.043).
CONCLUSION
Prediction accuracy of all ESCRS IOL Calculator formulas was high and globally comparable. TK-based calculations did not increase prediction accuracy and tended towards hyperopia. Observations indicating formula superiority in long and short eyes merit further evaluation.
PubMed: 38940463
DOI: 10.1097/j.jcrs.0000000000001512 -
Turkish Journal of Ophthalmology Jun 2024To report ocular manifestations in patients with Fabry disease (FD) from a tertiary eye care center in Türkiye.
OBJECTIVES
To report ocular manifestations in patients with Fabry disease (FD) from a tertiary eye care center in Türkiye.
MATERIALS AND METHODS
This prospective, cross-sectional study included 30 eyes of 15 patients with FD. The diagnosis of FD was made based on a combination of clinical findings, genetic analysis, and biochemical evaluation. All participants underwent a detailed ophthalmic examination with special focus on the typical ocular features of FD (cornea verticillata, conjunctival aneurysms, cataract, retinal vessel tortuosity).
RESULTS
The mean age was 45±17 years (range: 22-75 years), with a female/male ratio of 2:3. All patients had tortuous conjunctival vessels and 12 patients (80%) had conjunctival aneurysms. Cornea verticillata was present in 10 patients (66.6%), lens opacification in 4 patients (26.6%), and retinal vascular tortuosity in 8 patients (53.3%). All patients had at least two different ocular findings; most (3 heterozygotes/7 hemizygotes) had a combination of corneal verticillata and conjunctival vessel abnormality. The conjunctiva, cornea, and retina were affected together in 5 hemizygous patients (33.3%). One hemizygous patient had all FDrelated ocular manifestations in both eyes.
CONCLUSION
To our knowledge, this study is the first to describe the ocular manifestations of FD in the Turkish population. Although cornea verticillata is considered a hallmark of FD, it was absent in approximately one-third of patients. Moreover, cataract, another well-known feature of FD, was present in only 26.6% of the patients. Conjunctival vascular abnormality alone seems to be quite rare in FD, although it often accompanies other ocular manifestations. Therefore, recognition of other mild findings and special consideration of their associations may increase the diagnostic value of ocular findings in FD.
Topics: Humans; Fabry Disease; Female; Male; Adult; Middle Aged; Cross-Sectional Studies; Prospective Studies; Tertiary Care Centers; Aged; Young Adult; Turkey; Conjunctiva; Eye Diseases; Visual Acuity; Cornea; Conjunctival Diseases
PubMed: 38940325
DOI: 10.4274/tjo.galenos.2024.09482 -
Current Eye Research Jun 2024Posterior capsule opacification (PCO) is the major complication of visual impairment after cataract surgery. Circular RNAs (circRNAs) are involved in the development of...
PURPOSE
Posterior capsule opacification (PCO) is the major complication of visual impairment after cataract surgery. Circular RNAs (circRNAs) are involved in the development of many diseases. The purpose of this study was to explore the role and molecular mechanism of circ_0000099 in PCO.
METHODS
SRA01/04 cells were treated with TGF-β2 to establish a PCO cell model. The expression of circ_0000099, miR-223-3p, and connective tissue growth factor (CTGF) mRNA was determined by real-time quantitative polymerase chain reaction (qRT-PCR). Western blot assay was used to analyze the protein expression. Cell proliferation, migration, and invasion were analyzed by (4-5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), 5-ethynyl-2 '-Deoxyuridine (EdU), transwell, and wound healing tests. The circ_0000099/miR-223-3p/CTGF relationship was verified by dual luciferase reporter gene and RNA binding protein immunoprecipitation (RIP) assays.
RESULTS
TGF-β2 treatment promoted SRA01/04 cell proliferation invasion, migration, and EMT. Circ_0000099 expression was increased in POC patients and TGF-β2-treated SRA01/04 cells.Knockdown of circ_0000099 suppressed TGF-β2-induced proliferation, invasion, migration, and EMT in SRA01/04 cells. miR-223-3p was identified as the target of circ_0000099, and miR-223-3p inhibitor might partly abolish the repression of circ_0000099 silencing on TGF-β2-triggered SRA01/04 cell disorders. MiR-223-3p directly targeted CTGF. Knockdown of CTGF suppressed TGF-β2-induced SRA01/04 cell injury. Circ_0000099 can regulate CTGF expression by targeting miR-223-3p.
CONCLUSIONS
Circ_0000099 silencing might relieve TGF-2-induced SRA01/04 cell injury by the miR-223-3p/CTGF axis, providing new avenues for the prevention and treatment of PCO.
PubMed: 38940233
DOI: 10.1080/02713683.2024.2357600 -
Clinical & Experimental Ophthalmology Jun 2024Paediatric vitreoretinal pathology is distinct from adult cases in both presentation and surgical planning. Here we aim to report the aetiology and epidemiology in...
BACKGROUND
Paediatric vitreoretinal pathology is distinct from adult cases in both presentation and surgical planning. Here we aim to report the aetiology and epidemiology in children 0-18 years requiring vitreoretinal surgery at a major tertiary paediatric hospital in Queensland, Australia.
METHODS
Retrospective review of cases requiring vitreoretinal surgery between May 2015 and October 2022 was conducted. Demographics, ocular and medical history, surgical pathology, procedures performed, and epidemiology data were retrieved. Patients were grouped into three main aetiologies: traumatic, syndromic, or secondary.
RESULTS
A total of 124 patients, the majority male (87, 70.2%) with a mean age of 10.3 years underwent vitreoretinal surgery. Trauma accounted for 32.3% of cases requiring surgery of which 47% were due to a penetrating eye injury. 35.5% were associated with a syndromic cause with common aetiology including coats, congenital cataract, sticklers, and retinopathy of prematurity. 32.3% developed secondary pathology and retinal detachment was the primary cause for surgery (55%). The average time from symptom onset to presentation was 30 days (SD 56.88) with patients living an average of 306.2 km (SD 558.9) away from the Queensland Children's Hospital. Older age was significantly associated with increased days to presentation in the traumatic group (p < 0.05).
CONCLUSIONS
This study provides an insight into the aetiology and epidemiology of paediatric vitreoretinal presentations in Queensland, Australia.
PubMed: 38937978
DOI: 10.1111/ceo.14413 -
International Ophthalmology Jun 2024Age-related cataract (ARC) is the most common cause of visual impairment and blindness in older adults. However, the role of CUL4B in the ARC remains unclear. Therefore,...
PURPOSE
Age-related cataract (ARC) is the most common cause of visual impairment and blindness in older adults. However, the role of CUL4B in the ARC remains unclear. Therefore, we investigated CUL4B expression and its effects on apoptosis.
MATERIALS AND METHODS
CUL4B expression levels were detected by a quantitative real-time polymerase chain reaction from the anterior lens capsules of patients with ARC and HLE-B3 cells treated with different concentrations of HO. CUL4B expression was silenced by siRNA transfection to evaluate apoptosis. CUL4B and apoptotic proteins B cell lymphoma 2 (Bcl-2), myeloid cell leukemia 1 (Mcl-1), caspase-3, cleaved caspase-3, Bax, Bak, and Bid were assessed using western blot analysis. Apoptosis was monitored using the TUNEL assay.
RESULTS
CUL4B expression was downregulated in the anterior lens capsules (P < 0.0001) and HO-treated HLE-B3 cells (P = 0.0405). CUL4B protein levels were significantly lower in 100 µmol/L (P = 0.0012) and 200 µmol/L (P = 0.0041) HO-treated HLE-B3 cells than in the untreated cells. CUL4B expression was significantly knocked down at the mRNA (P = 0.0043) and protein levels (P = 0.0002) in HLE-B3 cells. Bcl-2 (P = 0.0199), Mcl-1 (P = 0.0042), and caspase-3 (P = 0.0142) were significantly downregulated, whereas cleaved caspase-3 (P = 0.0089) and Bak (P = 0.009) were significantly upregulated in the knockdown group. The TUNEL assay showed a greater induction of apoptosis.
CONCLUSIONS
CUL4B downregulation promotes the apoptosis of lens epithelial cells. Our study may help in understanding the role of CUL4B in ARC pathogenesis.
Topics: Humans; Cataract; Cullin Proteins; Apoptosis; Male; Female; Aged; Blotting, Western; Real-Time Polymerase Chain Reaction; Middle Aged; Aging; Gene Expression Regulation; Lens Capsule, Crystalline; In Situ Nick-End Labeling
PubMed: 38937308
DOI: 10.1007/s10792-024-03011-1 -
PloS One 2024To evaluate structural alterations and healing responses in the trabecular meshwork region with optical coherence tomography (AS-OCT) following after gonioscopy assisted...
PURPOSE
To evaluate structural alterations and healing responses in the trabecular meshwork region with optical coherence tomography (AS-OCT) following after gonioscopy assisted transluminal trabeculotomy (GATT) and microincisional trabeculectomy (MIT).
METHODS
73 eyes of 67 patients (M:F = 45:22) with ≥6 months of follow-up after MIT (n = 41) or GATT (n = 32) with or without combined cataract surgery were included for this prospective study. The angle as seen on AS-OCT at 1, 3, 6 months after surgery were evaluated for structural alterations like peripheral anterior synechiae (PAS), hyphema, and hyperreflective scarring responses. The scarring was graded according to the linear extent measured from the centre of the trabecular meshwork (TM) gutter to the sclera/cornea as mild (<250μ), moderate (250-500μ), and severe(˃500μ), while the pattern of scarring was graded as open saucer/gutter, closed gutter, and trench pattern. The association of the need for medication or surgical outcome and clinical variables and AS-OCT parameters including the pattern and severity of scarring were analysed using multivariate regression.
RESULTS
All eyes achieved significant reduction of IOP and number of medications with a final IOP of 15±3.2mm Hg at a mean follow-up of 8±32. months. While mild scarring was seen more common in MIT, severe scarring was seen in >65% of GATT eyes compared to 31% of MIT eye, p<0.001. An open saucer was equally seen in MIT and GATT while the trench pattern was more commonly seen in GATT eyes (>50%). Severe scarring in a trench pattern seemed to predict the need for medications for IOP control, though they independently did not seem to influence the final IOP or surgical outcome.
CONCLUSION
A severe form of scarring in a trench pattern on AS-OCT predicted the need for glaucoma medications after MIGS surgery. Regular monitoring of the scarring responses by AS-OCT and clinical examination are necessary to identify those at need for medications after MIGS.
Topics: Humans; Male; Tomography, Optical Coherence; Female; Aged; Trabeculectomy; Middle Aged; Glaucoma; Prospective Studies; Trabecular Meshwork; Wound Healing; Intraocular Pressure; Gonioscopy; Treatment Outcome
PubMed: 38935644
DOI: 10.1371/journal.pone.0305740 -
JAMA Ophthalmology Jun 2024Capsular tension rings (CTRs) can support weak zonules and inhibit capsular shrinkage, thus potentially reducing intraocular lens (IOL) decentration and tilt. However,...
IMPORTANCE
Capsular tension rings (CTRs) can support weak zonules and inhibit capsular shrinkage, thus potentially reducing intraocular lens (IOL) decentration and tilt. However, it has been debated whether CTRs can reduce IOL decentration and tilt in highly myopic eyes and whether CTR implantation is necessary for all highly myopic eyes.
OBJECTIVE
To evaluate the influence of CTR implantation on IOL decentration and tilt in highly myopic eyes.
DESIGN, SETTING, AND PARTICIPANTS
This randomized clinical trial was conducted between November 2021 and September 2023 at the Zhongshan Ophthalmic Center, Guangzhou, China. Patients with cataract and an axial length (AL) of 26 mm or longer were enrolled.
INTERVENTIONS
Participants were stratified into 3 groups based on the AL (stratum 1, 26 mm ≤ AL <28 mm; stratum 2, 28 mm ≤ AL <30mm; stratum 3, AL ≥30 mm), and further randomly assigned to the CTR group (a C-loop IOL combined with a CTR) or the control group (only a C-loop IOL) within each stratum.
MAIN OUTCOMES AND MEASURES
IOL decentration at 3 months after cataract surgery was evaluated using anterior segment optical coherence tomography.
RESULTS
A total of 186 eyes of 186 participants (mean [SD] age, 57.3 [10.9] years; 118 female [63.4%]) were randomized into the CTR group (93 [50%]) or control group (93 [50%]), with 87 eyes (93.6%) and 92 eyes (98.9%) completing follow-up at 3 months, respectively. The CTR group showed smaller IOL decentration (0.19 mm vs 0.23 mm; difference, -0.04 mm; 95% CI, -0.07 to -0.01 mm; P = .02) and tilt at 3 months, and lower proportions of clinically significant IOL decentration (≥0.4 mm) and tilt (≥7°) at 3 months compared with the control group. Similar results were only found in eyes with an AL of 30 mm or longer (IOL decentration: 0.20 mm vs 0.28 mm; difference, -0.08 mm; 95% CI, -0.14 to -0.02 mm; P = .01). Additionally, the CTR group showed a smaller change in IOL decentration from 1 week to 3 months, higher prediction accuracy, and better visual quality and patient satisfaction in this stratum. No differences were observed between the CTR and control groups in eyes with an AL less than 30 mm.
CONCLUSIONS AND RELEVANCE
CTR implantation reduced C-loop IOL decentration and tilt, increased position stability, and improved visual quality in eyes with an AL of 30 mm or longer. These findings support use of CTR implantation in eyes with an AL of 30 mm or longer and implanted with C-loop IOLs.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT05161520.
PubMed: 38935400
DOI: 10.1001/jamaophthalmol.2024.2215 -
International Ophthalmology Jun 2024To evaluate the agreement between the Goldman applanation tonometer (GAT), Tono-Pen, and noncontact tonometer (NCT) in the measurement of intraocular pressure (IOP) in... (Comparative Study)
Comparative Study
BACKGROUND
To evaluate the agreement between the Goldman applanation tonometer (GAT), Tono-Pen, and noncontact tonometer (NCT) in the measurement of intraocular pressure (IOP) in pseudophakic children.
METHODS
The medical records of nonglaucomatous pseudophakic children between 2009 and 2019 were retrospectively analyzed. A total of 46 eyes of 23 patients operated for bilateral pediatric cataract were included in the study. The patients' mean age was 13.4 ± 4.1 years. Central corneal thickness (CCT) and IOP values measured with the GAT, Tono-Pen, and NCT were recorded. Agreement between the tonometers was evaluated by intraclass correlation coefficients (ICC) and the Bland-Altman method.
RESULTS
The mean IOP of the 46 eyes included in the study was measured as 13.7 ± 2.3 mm Hg with the GAT, 16.0 ± 2.3 mm Hg with NCT, and 16.5 ± 2.3 mm Hg with the Tono-Pen (p < 0.001). There is no statistical difference between NCT and Tono-Pen measurements, while GAT measurements were significantly lower than those of the NCT and Tono-pen. ICC values showed fair agreement between NCT and Tono-Pen (ICC = 0.720), whereas there was poor agreement between GAT and NCT (ICC = 0.501) and Tono-pen (ICC = 0.314).
CONCLUSIONS
With all devices included in the study, thicker corneas were associated with higher IOP measurements. Although there was moderate agreement between the NCT and Tono-Pen, there was a statistically significant difference in the IOP values provided by the three devices. Our results suggest these devices should not be used interchangeably.
Topics: Humans; Intraocular Pressure; Tonometry, Ocular; Female; Male; Retrospective Studies; Child; Pseudophakia; Adolescent; Reproducibility of Results; Child, Preschool; Cornea
PubMed: 38935310
DOI: 10.1007/s10792-024-03210-w -
American Journal of Ophthalmology Case... Sep 2024To present a case involving a rarely seen prototype posterior chamber phakic IOL (PC-pIOL) in a highly myopic patient with bilateral cataract.
PURPOSE
To present a case involving a rarely seen prototype posterior chamber phakic IOL (PC-pIOL) in a highly myopic patient with bilateral cataract.
OBSERVATIONS
A 64-year-old male presented to our clinic with poor vision in both eyes. Clinical examination revealed bilateral mature cataract, phacodonesis as well as a PC-pIOL implanted 35 years ago to address his high myopia. The visual acuity (VA) was 20/200 in the right eye and no light perception in the left eye. PC-pIOL extraction as well as 23G pars plana vitrectomy (PPV) and fragmentation surgery was scheduled for the right eye. The left eye was treated conservatively. Successful extraction of the PC-pIOL was performed while it was easy to remove. It was a bow-tie shaped lens with a collar-stud-like button in the middle which extended anteriorly into the anterior chamber through the pupil. PPV with lens fragmentation was successful and the patient was left aphakic in order to avoid the placement of a zero diopter IOL. Final best corrected VA was 20/25 one month post-surgery.
CONCLUSIONS AND IMPORTANCE
Removal of this rarely seen pIOL was performed without difficulty while excellent VA was achieved. Aphakia following complete vitrectomy represented a viable option in this case. Furthermore, we highlight the clinical manifestations associated with this IOL more than three decades after implantation.
PubMed: 38933452
DOI: 10.1016/j.ajoc.2024.102086