International journal of ophthalmology最新文献

Aim: To investigate the influence of postoperative intraocular lens (IOL) positions on the accuracy of cataract surgery and examine the predictive factors of postoperative biometry prediction errors using the Barrett Universal II (BUII) IOL formula for calculation.

Methods: The prospective study included patients who had undergone cataract surgery performed by a single surgeon from June 2020 to April 2022. The collected data included the best-corrected visual acuity (BCVA), corneal curvature, preoperative and postoperative central anterior chamber depths (ACD), axial length (AXL), IOL power, and refractive error. BUII formula was used to calculate the IOL power. The mean absolute error (MAE) was calculated, and all the participants were divided into two groups accordingly. Independent t-tests were applied to compare the variables between groups. Logistic regression analysis was used to analyze the influence of age, AXL, corneal curvature, and preoperative and postoperative ACD on MAE.

Results: A total of 261 patients were enrolled. The 243 (93.1%) and 18 (6.9%) had postoperative MAE<1 and >1 D, respectively. The number of females was higher in patients with MAE>1 D (χ ² = 3.833, P=0.039). The postoperative BCVA (logMAR) of patients with MAE >1 D was significantly worse (t=-2.448; P=0.025). After adjusting for gender in the logistic model, the risk of postoperative refractive errors was higher in patients with a shallow postoperative anterior chamber [odds ratio=0.346; 95% confidence interval (CI): 0.164, 0.730, P=0.005].

Conclusion: Risk factors for biometry prediction error after cataract surgery include the patient's sex and postoperative ACD. Patients with a shallow postoperative anterior chamber are prone to have refractive errors.

Aim: To evaluate the efficacy and safety of microcatheter-assisted 360-degree trabeculotomy combined with trabeculectomy (MATT-Trab) for treating refractory glaucoma.

Methods: Patients with refractory glaucoma who underwent MATT-Trab were retrospectively examined. Efficacy indicators for research statistics included the intraocular pressure (IOP) level, degree of decrease, changes in medication dosage, and success rate. Safety indicators included the best-corrected visual acuity and incidence of complications.

Results: This study comprised 31 patients, including 11 males and 20 females, with ages ranging from 8mo to 67y (mean age: 29.40±22.10y). The average postoperative IOP at 1d, 1wk, 1mo, 3mo, 6mo, 1y, and the last follow-up was significantly lower than the average preoperative IOP (31.33±9.24 mm Hg, P<0.05). The average number of postoperative medications at 1y was 0.48±1.51, which was significantly reduced compared to that used preoperatively (3.77±0.99, P=0.00). The absolute and qualified success rates were 45.16% and 83.87%, respectively. Visual acuity exhibited no statistically significant difference between the postoperative and preoperative follow-up time points, except for the first day after surgery. The most common postoperative complications were anterior chamber hemorrhage (25 cases, 86.21%) and high IOP (10 cases, 34.48%).

Conclusion: Our results indicate that MATT-Trab is effective and safe for treating refractory glaucoma.

Aim: To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus (EDOF) intraocular lens (IOL) in individuals with ocular hypertension (OHT) and well-controlled mild glaucoma undergoing cataract surgery.

Methods: An investigator-initiated, single-center, prospective, interventional, noncomparative study conducted in Montreal, Canada. The study enrolled 31 patients (55 eyes) with OHT or mild glaucoma who received a non-diffractive EDOF IOL (Acrysof IQ Vivity). Participants underwent sequential cataract surgery with the Vivity IOL. Follow-up evaluations occurred at 1d, 1, and 3mo postoperatively, assessing uncorrected distance, intermediate, and near visual acuity. Questionnaires (QUVID: Questionnaire for visual disturbances and IOLSAT: Intraocular lens satisfaction) were administered pre and post-operatively to measure visual disturbances and spectacle independence in various lighting. Safety parameters included intraocular pressure (IOP), glaucoma medications, spherical equivalence, mean deviation and pattern standard deviation or square root of lost variance on Octopus visual field.

Results: At 1 and 3mo postoperatively, significant improvements were observed in uncorrected distance and intermediate visual acuity. Spectacle independence was enhanced for distance and intermediate vision, especially in bright light settings. Spectacle-free intermediate vision was improved even in dim lighting. Visual disturbances, particularly glare symptoms, were reduced, and there was a notable decrease in IOP and glaucoma medication burden at 3mo. There was more hazy vision postoperatively with no impact on visual acuity and visual satisfaction.

Conclusion: The non-diffractive EDOF lens improves distance and intermediate spectacle-free visual function in patients with OHT and well-controlled glaucoma. The findings highlight significant improvements in visual acuity, reduced glare, enhanced spectacle independence, and improved visual performance in different lighting conditions.

Aim: To evaluate the short-term efficacy of XEN45 Gel Stent (XEN) implantation for primary open angle glaucoma (POAG) and pseudoexfoliation (PEX) glaucoma across two university eye clinics, aiming to assess the impact of varying center-specific protocols during the first postoperative year.

Methods: We retrospectively examined 282 patients (183 in center 1, 99 in center 2), who underwent XEN microstent implantation for uncontrolled POAG or PEX glaucoma. Parameters including intraocular pressure (IOP), IOP-lowering medication count, best corrected visual acuity (BCVA), and postoperative complications were evaluated over 12mo.

Results: Post-implantation, center 1 reported a mean IOP reduction from 25.3±7.4 to 14.1±4.7 mm Hg (P<0.01) and a decrease in IOP-lowering medications from 3.2±1.2 to 1.0±1.3 (P<0.01). Center 2 observed a similar reduction from 24.4±6.5 to 15.1±5.5 mm Hg (P<0.01) and medication decrease from 3.0±1.1 to 1.2±1.0 (P<0.01). BCVA remained stable in both cohorts. The most common complications were hypotony (center 1: 32; center 2: 20) and choroidal detachment (center 1: 22, center 2: 15), with nearly identical needling rates (40% in center 1, 41% in center 2).

Conclusion: XEN implantation yields consistent reductions in IOP and medication use across different centers using comparable surgical and postoperative treatment regime. These findings underscore XEN's short-term effectiveness and suggest standardizable outcomes regardless of exact surgical procedure or treatment differences.

Aim: To evaluate the effect of femtosecond laser small incision lenticule extraction (SMILE) on the binocular visual function in myopic patients with glasses-free three-dimensional (3D) technique.

Methods: Totally 50 myopic patients (39 females and 11 males) with SMILE were enrolled in this prospective study. The glasses-free 3D technique was used to evaluate the binocular visual function in these subjects including static stereopsis, dynamic stereopsis, foveal suppression, and binocular balance point of signal to noise ratio (s/n ratio). All subjects received measurements in 1d before operation, and 1d, 1wk, and 1mo postoperatively.

Results: Both static and dynamic stereopsis showed no significant difference after SMILE. The foveal suppression improved significantly 1wk and 1mo after SMILE (P=0.005 and P=0.007 respectively). The binocular balance point of signal to noise ratio showed a significant improvement 1d, 1wk and 1mo after SMILE for both eyes (P<0.001 for each eye respectively).

Conclusion: Glasses-free 3D technique can be used to evaluate the effect of SMILE on the binocular visual function in myopic patients perceptively, and SMILE can improve both foveal suppression and binocular imbalance in these patients.

Aim: To test the effect of autophagy on inflammatory damage resulting from oxidative stress in adult retinal pigment epithelial cell line (ARPE-19).

Methods: ARPE-19 cells were pretreated with 200 and 600 µmol/L hydrogen peroxide (H₂O₂) at various time intervals. The changes of cell morphology, cell viability, reactive oxygen species (ROS) level, autophagic activity, and the inflammatory cytokines (TNFα, IL-6, and TGFβ) were measured at baseline and after treatment with autophagy inducer rapamycin (Rapa) and suppressor wortmannin (Wort) or shATG5.

Results: The levels of ROS, cytokines (TNFα, IL-6, and TGFβ), and autophagic activity were significantly increased in ARPE-19 cells after pretreated with H₂O₂ (all P<0.05) and IL-10 was significantly decreased (P<0.05). By upregulating autophagy, Rapa significantly reduced oxidative stress-induced secretion of pro-inflammatory factors (TNFα and IL-6) and ROS (all P<0.05), yet elevated the production of TGFβ (P<0.05). In contrast, suppression of autophagy through Wort or ATG5 knockdown reduced cell viability, increased cell apoptotic rate, and exacerbated the generation of ROS and inflammatory cytokines (TNFα, IL-6, and TGFβ; all P<0.05).

Conclusion: Autophagy demonstrates a protective effect on ARPE-19 cell through mitigating oxidative damage and oxidative stress-induced inflammatory response. Regulation of autophagy may be a potential way for age-related macular degeneration.

Improvements in surgical techniques have led to 90% success in the surgical repair of rhegmatogenous retinal detachment (RRD). However, anatomical reattachment of the retina does not ensure complete recovery of visual function. The incidence of metamorphopsia remains the most common postoperative complaint, from 24% to 88.6%. Currently, the risk factors of metamorphopsia are categorized into macular involvement, retinal shift, outer retinal folds, subretinal fluid, secondary epiretinal membrane, outer retinal layer damage, and surgical approach. The associations of metamorphopsia with postoperative best-corrected visual acuity and postoperative vision-related quality of life were still controversial. The most popular methods for assessment of metamorphopsia remain the Amsler grid and M-Charts. Most treatments cannot progress beyond the management of negative visual sensations, through methods such as occlusion therapy and aniseikonia-correcting spectacles. The main treatment approach involves RRD prevention and the management of risk factors that can lead to postoperative metamorphopsia after RRD repair. Additional research concerning metamorphopsia treatment, further upgrades of auxiliary inspection methods, and more accurate microstructural assessments are needed to address this common complication.

Aim: To explore the neuroprotective effects of high mobility group box 2 (HMGB2) knockdown on retinal ganglion cells (RGCs) in the retinal ischemia-reperfusion injury (RIRI).

Methods: Oxygen-glucose deprivation (OGD)-injured RGCs from postnatal three-day C57BL/6 mice pups and high intraocular pressure (IOP)-induced RIRI mice were used as cellular and animal models of RIRI. The expression of HMGB2 in the retina of RIRI mice and OGD-injured RGCs was detected through reverse transcription-polymerase chain reaction (RT-qPCR) and Western blotting. The effects of HMGB2 silencing on the morphological changes, RGCs survival, and cell apoptosis in mouse retinal tissues were observed through H&E staining, immunofluorescence staining with RNA-binding protein with multiple splicing (RBPMS) antibody, and TUNEL staining, respectively. RGC viability and apoptosis were examined by CCK-8 and flow cytometry assays. The levels of proteins associated with NOD-like receptor thermal protein domain associated protein 3 (NLRP3)-mediated pyroptosis [NLRP3, Caspase-1, GSDMD-N, interleukin (IL)-1β, IL-18] in vivo and in vitro were measured by Western blotting.

Results: HMGB2 protein and NLRP3 were upregulated in the retina of RIRI mice and OGD-injured RGCs (P<0.001). The retina was edematous, accompanied by disorganized cell arrangement and decreased thickness of all layers, and obvious vacuoles in ganglion cell layer. HMGB2 silencing alleviated the reduction in total retinal thickness and the severity of retinal tissue damage as well as suppressed RGC loss and retinal cell apoptosis in RIRI mice. OGD-induced RGC apoptosis was ameliorated after downregulation of HMGB2 in vitro. Intravitreal injection of the AAV-sh-HMGB2 and si-HMGB2 resulted in significantly decrease of NLRP3, Caspase-1, GSDMD-N, IL-1β, and IL-18 protein levels in the retinal tissues of RIRI mice and OGD-injured RGCs, respectively (all P<0.001).

Conclusion: HMGB2 knockdown protects against RGC apoptosis and pyroptosis after RIRI through suppressing NLRP3 inflammasome activation.