Current Eye Research最新文献

Purpose: To evaluate the safety, efficacy, predictability, and stability of phakic refractive lens (PRL) implantation for the correction of super-high myopia.

Methods: This four-center prospective clinical study included 30 eyes from 16 myopic patients who underwent PRL implantation. The patients were followed up for one year, with evaluations of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction, intraocular pressure (IOP), vault, endothelial cell density (ECD), and axial length.

Results: One year postoperatively, eight eyes (27%) achieved a UDVA of 20/20 or better, and 21 eyes (70%) achieved a UDVA of 20/25 or better. The CDVA improved by one line in 22 eyes (73%), with one eye experiencing a loss of CDVA. The mean efficacy and safety index at one year were 1.30 ± 0.49 and 1.61 ± 0.32, respectively. No significant change was observed in the mean refractive spherical equivalent between one week and one year postoperatively. The axial length remained stable pre- and postoperatively. IOP increased significantly at 1 d and 1 week postoperatively (p = 0.002 and p < 0.001, respectively) but returned to preoperative levels by 1 month. ECD showed no significant change pre- and postoperatively except that 5 eyes from 4 patients had a postoperative ECD below 2000 cells/mm² caused by surgical trauma. The mean vault was 393.05 ± 243.54 µm at one week and 385.68 ± 157.41 µm at one year, showing no significant change.

Conclusion: PRL implantation for correction of super-high myopia demonstrated good safety, efficacy, predictability, and stability.

Introduction: Wearable light sensors allow for a more objective classification of a child's habitual light environment. The aim of this study was to develop an optimal illuminance and/or RGB irradiance thresholds as a proxy for distinguishing between indoor and outdoor environments through empirical analysis of data collected with the Actiwatch Spectrum PRO, as an example of wearable light-sensing technology.

Methods: Six participants, aged 18-22 y, wore an Actiwatch Spectrum PRO, for two consecutive days as they went about their daily activities. The Actiwatch was configured to record at 30 s epochs, both overall illuminance (lux) and irradiance (µW/cm2), for each of its three wavelength channels (R, G, B). Using the Actiwatch's scoring feature, participants indicated changes in their environment and its type, i.e. indoors or outdoors. For each individual dataset, mean illuminance, as well as mean red, green, and blue irradiances were calculated for each event, i.e. interval spent in a particular environment. Criteria for distinguishing between indoor and outdoor environments were evaluated using ROC analyses.

Results: Based on the collected data, a 1000 lux white light threshold, which has been commonly used to distinguish between outdoor and indoor settings, resulted in significant misclassification of reported outdoor events (sensitivity: 43.5%, specificity: 93.6%). The use of two time-dependent red light irradiance thresholds covering sunrise to 2 pm, and 2 pm to sunset, proved to more reliably identify outdoor settings (sensitivity: 85.1%, specificity: 82.6%).

Conclusion: In this small-scale study of the Actiwatch Spectrum Pro, derived red light irradiance thresholds out performed the more commonly used 1000 lux white light threshold in correctly classifying indoor and outdoor environments. In this context, the potential utility of wavelength-dependent irradiance cutoff values warrants further investigation, with due consideration to study-specific differences in geographic locations, climate and season.

Purpose: The aim of this study was to develop a 3D-printed eye model to simulate measuring intraocular pressure (IOP) as a training device, and to assess the correlation between measured IOP using common clinical techniques and actual internal pressure.

Methods: The IOP eye model was designed using CAD software and printed with a resin stereolithography (SLA) 3D-printer (Formlabs 3B, Formlabs Inc., MA, USA). Two clinical instruments, Tono-pen (Tono-Pen AVIA, Reichert Ophthalmic Instruments, USA), and Perkins hand-held tonometer (Clement Clarke Perkins Tonometer Mk2, Vision Equipment Inc., USA) were used for IOP measurements of the model. The pressure within the model was adjusted between 7 to 55 mmHg at 5 mmHg increments, and the IOP values of the tonometry were correlated to the internal pressure displayed on the gauge.

Results: The IOP model could reliably produce internal pressure from 0 to 56 mmHg. The results showed that the Tono-pen measurements above 7 mmHg were closely correlated to the internal pressure obtained from the pressure gauge (Pearson r = 0.99, p < 0.0001). However, aligning the mires and measuring IOP accurately with the Perkins device was challenging.

Conclusion: The 3D-printed eye model was able to strongly correlate IOP readings taken with a Tono-pen with internal pressure measured by a pressure gauge. The internal pressure of this model can be regulated and is envisioned as a potential model for practicing tonometry at different ranges of pressure.

Purpose: Sex hormone changes, often occurring during menopause, are implicated in meibomian gland dysfunction (MGD) and evaporative dry eye disease (DED). This study aimed to evaluate whether menopausal status affects the treatment outcomes of perfluorohexyloctane eye drops.

Methods: This post hoc analysis used data from a phase 3 trial (NCT05515471) of perfluorohexyloctane eye drops in patients with DED associated with MGD. The efficacy and safety of perfluorohexyloctane compared with 0.6% saline were evaluated within each menopausal status subgroup (premenopausal or postmenopausal), and the interaction between treatment and menopausal status was assessed.

Results: In total, 245 women (94 postmenopausal and 151 premenopausal) were included. In the postmenopausal subgroup, the propensity score weighted least-squares mean differences (LSMD) in changes from baseline to day 57 in total corneal fluorescein staining (tCFS) score and eye dryness score (EDS) between perfluorohexyloctane and saline were -1.0 (95% CI, -2.0, 0.0) and -7.9 (95% CI, -15.6, -0.2), respectively. In the premenopausal subgroup, the propensity score weighted LSMD in changes from baseline to day 57 in tCFS score and EDS were -1.4 (95% CI, -2.3, -0.5) and -14.0 (95% CI, -20.3, -7.8), respectively. Both subgroups showed improvements in some DED symptoms. No statistically significant interaction was observed between menopausal status and treatment across all measured outcomes. Perfluorohexyloctane was well tolerable in both subgroups.

Conclusions: Perfluorohexyloctane eye drops improved signs and symptoms of DED associated with MGD and were safe in both postmenopausal and premenopausal women. Further studies are needed to confirm the influence of menopausal status on perfluorohexyloctane efficacy.

Trial registration: ClinicalTrials.gov identifier, NCT05515471.

Purpose: To study the correlation between uncorrected distance visual acuity (UCVA) and myopic refractive error among school-aged children.

Methods: The North India Myopia study is a prospective cohort study in which school children were screened for refractive error. These children were subsequently followed up to note the incidence and progression of myopia. The methodology of the study is as previously described. Children with UCVA < 3/60 were excluded for this analysis, since they are more likely to be associated with other ocular pathologies.

Results: Of the 9884 children screened, 1463 children fulfilled the inclusion criteria for this analysis. UCVA was plotted against the mean prescribed Spherical equivalent (SE), with a 95% confidence interval. Marginal predictions of prescribed power according to UCVA were calculated using linear regression, enabling the development of a nomogram to estimate the closest SE based on UCVA.

Conclusion: There is a steady correlation between the UCVA and degree of myopic refractive error among school going children. This correlation has been utilized to develop this nomogram that may help predict myopic refractive error on the basis of uncorrected visual acuity. Large scale studies are needed for the validation of this nomogram in different populations.

Purpose: To assess the usability of a smartphone-based augmented reality tool for capsulorhexis training.

Methods: This is a single-center, prospective, clinical study conducted at the Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany. Surgery-naïve residents were included and divided into three subgroups: (1) augmented reality supported by the Custom Surgical MicroREC system during their capsulorhexis procedures; (2) Expert support supported by an experienced cataract surgeon; (3) No support without support. Capsulorhexis quality was graded by circularity, centration, and radius.

Results: Twenty-one (n_total = 21) participants were enrolled. The augmented reality group was statistically significantly better in terms of circularity than the Expert support (Mann-Whitney's U-test: p = .00175) and the No support group (Mann-Whitney's U-test: p = .00268). The procedure duration decreased statistically significantly for all three groups when try 1 and 10 were compared (augmented reality: p < .0001; Expert support: p = .0099; No support: p < .0001). The other parameters did not differ statistically significantly. The questionnaires handed to the augmented reality and No support group before and after the wet lab revealed a high importance of wet lab trainings to all polled participants. The provided wet lab setup was considered adequate by both groups.

Conclusion: Augmented reality can assist in cataract training. The Custom Surgical MicroREC system can have a positive influence on capsulorhexis quality in a training environment. Automated quality metrics measured by the augmented reality software provide an objective quality score of the performed surgical procedure. As the tested augmented reality system can be used in training as well as in a real-world setting, this will be a useful tool for trainees and expert surgeons alike.

Purpose: To investigate the oxidative stress (OS) and inflammatory cytokine (IC) levels in vitreous and subsilicone fluid (SSF) in cases with rhegmatogenous retinal detachment (RRD).

Methods: This prospective study included 21 cases of uncomplicated RRD. Total antioxidant status (TAS) and total oxidant status (TOS) in the samples were determined by automatic measurement method and IC levels were determined by ELISA method. In addition to routine ophthalmological examinations, flare, optic coherence tomography (OCT) and enhanced depth imaging-OCT measurements were performed during follow-up.

Results: There was a significant difference in the TOS and oxidative stress index (OSI) in SSF compared to vitreous (p < 0.05). IL-1β level was detected significantly higher in vitreous fluid (p = 0.004). When the correlation between TAS, TOS, OSI and cytokine levels in SSF and the difference in central macular thickness (CMT), choroidal thickness and flare changes measured in the 1st and 3rd month follow up of the cases after vitrectomy were evaluated, only negative correlation was observed between TOS, OSI, and CMT.

Conclusion: OS, which has not been previously investigated in SSF, was significantly higher in this study, and our findings suggest that OS may have an initiating role in retinal damage thought to be caused by silicone oil.

Purpose: To determine histological effects of myopia progression control (MPC) lens-induced refractive changes on scleral remodeling in chicks.

Methods: 24 Ross-Ross chicks were raised for 14 days. 6 chicks wore conventional -10D lenses for 7 days, followed by no lenses for 7 days. 6 chicks wore conventional -10D lenses for the full 14 days. 6 chicks wore conventional -10D lenses for 7 days, followed by +10D lenses for 7 days. 6 chicks wore conventional -10D lenses for 7 days, followed by MPC lenses for 7 days. MPC lenses had a central power of -10D and a gradient power rise at pupil edge (+2.75D). Chicks were euthanized after 14 days and eyes were processed for histopathological evaluation. Whole mount H&E-stained tissue sections were analyzed using bright field microscopy.

Results: Total scleral thickness was significantly reduced in the group wearing conventional -10D lenses (p < 0.05) but remained comparable to the control group for MPC lenses treated chicks. Appositional growth of the cartilaginous sclera (CS) was observed in all MPC lenses treated eyes and only in those eyes. There was a significant increase in CS thickness in MPC lenses treated chicks compared to the other two groups (p < 0.03) but not between conventional -10D lens treated and control chicks (p > 0.05).

Conclusion: It is possible to induce appositional growth in hyaline cartilage in the chick sclera. In our study, this has only been achieved by using MPC lenses to reverse previously induced experimental myopia with conventional minus lenses. Our findings suggest that a gradient decrease in peripheral lens power and the resulting differential defocus could trigger of scleral reinforcement through of cartilage growth stimulation in the chick sclera.

Purpose: To evaluate the expression differences of tear lymphotoxin-α (LT-α), total immunoglobulin E (IgE), and matrix metalloproteinase-9 (MMP-9) in seasonal/perennial allergic conjunctivitis-associated dry eye (S/PAC-DE) and their clinical relevance, probing the underlying pathogenesis of S/PAC-DE.

Methods: This study enrolled 37 S/PAC-DE patients, 23 dry eye (DE) patients, and 24 healthy controls (HC). Assessing the clinical parameters, tear LT-α, total IgE, MMP-9, and nine other inflammatory cytokines in the three groups. Correlations between tear cytokines and clinical parameters were also analyzed.

Results: Tear LT-α levels were significantly lower in S/PAC-DE compared to DE and HC groups. Tear total IgE, TNF-α, and MMP-9 levels were significantly upregulated in the S/PAC-DE group than those in the DE (all p < 0.001) and HC groups (p = 0.005, p < 0.001, and p = 0.048). In the S/PAC-DE group, total IgE was positively correlated with MMP-9 (r = 0.652, p = 0.008). Total IgE and LT-α were positively correlated in the DE group (r = 0.498, p = 0.016), while the two showed a negative correlation trend in the S/PAC-DE group (r=-0.272, p = 0.103). LT-α was positively correlated with tear film break-up time and negatively correlated with corneal fluorescein staining score in both the S/PAC-DE and DE groups.

Conclusions: In the S/PAC-DE co-morbid state, the inhibition of tear LT-α expression and the upregulation of the pro-inflammatory cytokines total IgE, TNF-α, and MMP-9 may collectively contribute to the disruption of the ocular surface epithelial barrier, further promoting and exacerbating DE. Additionally, the differences in correlation between LT-α and total IgE in the S/PAC-DE and common DE patients may be related to the distinct ocular immune microenvironments.