BMC Ophthalmology最新文献

Background: Digital eyestrain (DES) is a collection of ocular and vision symptoms caused by prolonged use of digital devices that can greatly impact schoolchildren's daily activities and learning. The main purpose of this study is to assess the prevalence of DES among schoolchildren and the associated risk factors in Palestine.

Methods: From the 1st of April 2024 to the 30th of May 2024, a total of 492 school children who met the criteria for DES screening in the selected schools were included in the study. A quantitative, cross-sectional design was utilized with a self-structured questionnaire. The sample consisted of schoolchildren aged 11 to 18 years. The questionnaire is structured into three sections: (1) Sociodemographic information, (2) Information regarding the digital device used, and (3) DES assessment by using the Computer Vision Syndrome Questionnaire, and the visual acuity was measured using the Snellen chart. The data was analyzed using SPSS version 25 with a 95% CI.

Results: The study analysis showed that 44.1% of school children experience DES. Snellen chart test analysis showed that 28.25% of students had results exceeding a score of six for either the right or left eye. For both eyes combined, (14.63%) of students had examination results greater than six. After conducting univariate analysis, statistically significant risk factors (p-value less than 0.05) affecting the development of DES in our study were posture, smartphone use at bedtime, and duration of device use, watching movies, social networking, and screen brightness. Moreover, females, older students, and those using devices closer than 30 cm or owning multiple devices reported higher eyestrain scores.

Conclusions: The current research found that Palestinian school children significantly experience eyestrain, indicating the influence of digital devices on eye health. The study results emphasize the need for early detection to prevent future eye health complications.

Purpose: This pilot study aimed to compare ocular biometric data obtained from Pentacam AXL and IOL Master 700 in patients with keratoconus who underwent intracorneal ring segment (ICRS) implantation.

Method: In this pilot study, patients who underwent ICRS implantation (between 2013 and 2021) at Khalili Hospital were assessed using pre-surgical examinations and biometry and keratometry measurements performed with the Pentacam AXL and the IOLMaster 700. The devices were used in random order, and measurements were conducted by expert operators who were blinded to each other's results. Data were analyzed using SPSS version 23.

Result: A total of 21 patients (mean age: 35.47 ± 6.43 years) who underwent ICRS implantation surgery were included. Significant mean differences between Pentacam AXL and IOL Master 700 were observed in anterior chamber depth (ACD), mean keratometry (KM), steep keratometry (K2), and white-to-white distance (WTW) (p < 0.05). No significant differences were found for axial length (AL), flat keratometry (K1), K1 and K2 meridians, or intraocular lens (IOL) power calculated using Haigis and SRK/T formulas (p > 0.05).

Conclusion: Significant differences in ACD, KM, K2, and WTW were observed between Pentacam AXL and IOL Master 700 in patients with ICRS implantation, while AL, K1, K1 meridian, K2 meridian, and IOL power calculations (Haigis and SRK/T) showed no differences. These findings underscore the importance of device selection tailored to specific clinical and biometric needs and suggest the necessity of larger studies to confirm these results.

Background: High anisometropia is often accompanied by amblyopia. One percent atropine penalization is an important treatment for anisometropic amblyopia and is as effective as occlusion therapy. On the other hand, 1% atropine had the strongest effect on controlling refractive error and axial length (AL) changes in myopic patients.

Case presentation: A female child was diagnosed with anisometropia at the age of two. Cycloplegic retinoscopy examination revealed refraction of + 2.5 diopters the right eye and -8.5/-1.5 × 120 diopters the left eye, and full correction spectacles and patching therapy were prescribed for the child. Anisometropic amblyopia was then diagnosed because the best corrected vision acuity in highly myopic eyes is 20/100. Owing to poor compliance, visual acuity recovery in the amblyopic eye was unsatisfactory, and 1% atropine was applied two times per week for the fellow (right) eye. Since then, the fellow eye has experienced rapid myopization, with the refractive error increasing to -7.5/-1.25 × 15 diopterswithin five years. In addition, the visual acuity of the amblyopic (left) eye has improved gradually to 20/20, although the refraction status has remained stable.

Conclusions: In this report, a high anisometropic amblyopia patient underwent rapid myopization in the fellow eye with constant use of 1% atropine, in contrast to the stable refraction status of the amblyopic eye.

Objective: To compare the efficacy of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS) in treating postvitrectomy cataracts.

Methods: Prospective randomized controlled study. Patients who underwent cataract surgery after pars plana vitrectomy (PPV) were randomly divided into the FLACS group and the CPS group. Preoperative data of all patients were collected to compare intraoperative complications, average phacoemulsification energy (AVE), effective phacoemulsification time (EPT), postoperative intraocular pressure, corneal endothelial cell density (ECD), and best corrected visual acuity (BCVA).

Results: A total of 92 eyes were included in the analysis, with 47 eyes in the FLACS group and 45 eyes in the CPS group. The intraoperative AVEs and EPTs in the FLACS group were both lower than those in the CPS group (P < 0.05). In the FLACS group, incomplete prechopping and incomplete capsulorhexis occurred in 3 eyes (3/47, 6.38%), and incomplete lens dislocation occurred in 1 eye (1/47, 2.13%). In the CPS group, incomplete lens dislocation occurred in 2 eyes (2/45, 4.44%), and anterior capsule tears occurred in 1 eye (1/45, 2.22%). There was no statistically significant difference in intraoperative complications between the two groups (P > 0.05). Postoperatively, intraocular pressure (IOP) was lower in both groups than preoperatively, and there was no statistically significant difference in intraocular pressure between the two groups at three months postsurgery (P > 0.05). Three months postoperatively, the ECD in the FLACS group was greater than that in the CPS group, with less average endothelial cell loss (ECL) than that in the CPS group (P < 0.01). The BCVA in both groups improved to varying degrees compared with the preoperative values, with the FLACS group performing better than the CPS group on the first postoperative day (P < 0.05). There was no statistically significant difference between the two groups at one week, one month, or three months postoperatively (all P > 0.05).

Conclusion: FLACS is safe and effective for treating post-PPV cataracts and, compared with CPS, facilitates early postoperative recovery with no difference in final visual acuity. Residual silicone oil in the anterior chamber post-PPV may lead to certain specific outcomes for FLACS. Although it may not affect surgical results, it is still noteworthy.

Background: Irreversible blindness is the natural history of untreated glaucoma; however, a significant proportion of those receiving treatment are still blind. This study sought to identify the determinant factors responsible for blindness from glaucoma among those receiving treatment.

Method: This retrospective cohort study collected data via chart review of glaucoma patients (N = 231) who attended eye clinics at a large government-owned or a privately owned health facility in Enugu, Nigeria, between October and December 2023. Visual acuity was used to determine whether the eyes met the criteria for blindness. The sociodemographic and clinical characteristics of glaucoma patients who were blind (105) and patients without blindness (126) were compared. Data analysis was performed via the statistical package for social sciences (SPSS) version 26. Binary logistic regression was used to identify determinants of blindness.

Results: The records of a total of 231 glaucoma patients were reviewed. One hundred and five (45.5%) patients were blind in at least one eye. The mean age was 61.1 ± 13.9 years (patients without blindness) and 63.6 ± 10.6 years (blind patients). Those living in urban areas (AOR = 0.49, 95%CI = 0.24-0.99), those with no visual impairment at presentation (AOR = 0.005, 95% CI = 0.000-0.055, p < 0.0001), those with mild to moderate visual impairment (AOR = 0.125, 95% CI = 0.06-0.277, p < 0.0001), and those with presenting IOP < 22 mmHg (AOR = 0.23, 95% CI = 0.09-0.546, p = 0.001) were significantly associated with a lower risk of blindness from glaucoma. However, being non-hypertensive was associated with a higher risk of blindness from glaucoma (AOR = 2.20, 95% CI = 1.16-4.18, p = 0.043).

Conclusion: Among patients receiving treatments for glaucoma, living in non-urban areas, presenting with severe visual impairments, presenting with IOP > 22 mmHg, and being non-hypertensive increased the risk of blindness. Improving access to glaucoma care in non-urban areas, increasing awareness creation on screening for early detection and patient counseling may be profitable steps towards reducing vision loss from glaucoma.

Aim: Diabetic patients suffer from severe dry eye after cataract surgery, and the aim of this study was to investigate the effect of 2.2 mm and 3.0 mm clear corneal incisions on dry eye after phacoemulsification in patients with type 2 diabetes mellitus (T2DM).

Methods: Clinical data of 104 patients with T2DM who underwent phacoemulsification in the Department of Ophthalmology of The People's Hospital of Yingshang from January 2022 to November 2023 were retrospectively collected. The patients were categorized into 2.2 mm and 3.0 mm groups according to the surgical incision, and their preoperative and postoperative Ocular surface disease index (OSDI), Schirmer I test (SIt), and Fluorescein breakup time (FBUT), as well as anxiety and depression levels, were analyzed.

Results: Before surgery, mild anxiety and depression were present in both groups. At 7 days and 1 month postoperatively, OSDI was significantly higher and SIt and FBUT were substantially lower in both groups, but the above indexes were milder in the 2.2 mm group. Meanwhile, the psychological status of both groups significantly improved at 1 month after surgery, and the improvement was more significant in the 2.2 mm group. At 3 months postoperatively, the dry eye of the two groups was relieved, and the psychological status was also improved.

Conclusion: Compared with 3.0 mm, a 2.2 mm clear corneal incision effectively reduced dry eye after phacoemulsification in T2DM patients.

Purpose: To study the added effect of sum-of-segments (SOS) biometry to modern intraocular lens power calculation formulas for eyes with short axial length.

Methods: This was a retrospective case series that included 99 eyes from 99 patients. Preoperative AXL measurements were conducted utilizing the ARGOS biometer (Alcon, Inc., Fort Worth, TX). The following formulas were used: Barrett Universal II (BUII), Cooke K6, EVO 2.0, and PEARL-DGS formulas. Additionally, the Barrett formula has been updated and is now incorporated into the ARGOS biometer, introducing the Barrett true axial length (BTAL) formula.

Results: EVO 2.0_sos and PEARL-DGS_sos formulas had the highest cases within ± 0.25 D of the intended refraction (45.45% and 42.42%, respectively). The PEARL-DGS_sos was the only formula to show a myopic mean prediction error (-0.25 ± 0.36 D). The Cooke K6 formula showed the highest hyperopic mean prediction error (0.55 ± 0.35 D), followed by EVO 2.0, Cooke K6_sos, and BUII formulas. BTAL had mean prediction error of 0.15 ± 0.47 which is less hyperopic than BUII (0.43 ± 0.39 D). Subgroup analysis of eyes with AXL 21 mm or shorter (n = 57) was done. Again, the PEARL-DGS_sos formula showed the only myopic mean prediction error (-0.23 ± 0.37 D).

Conclusion: PEARL-DGS_sos was the only formula to show a myopic mean prediction error. Using BTAL and SOS option in Cooke K6, EVO 2.0, and PEARL-DGS formulas decreased the undesirable hyperopic shift in the mean prediction error. This effect was more evident in shorter eyes ≤ 21.0 mm.

Purpose: Pars plana vitrectomy (PPV) is an effective treatment of vitreoretinal diseases, while some studies reported visual field defects after surgery. The aim of this study was to evaluate the protective effects of modified vitrectomy surgical conditions on peripapillary microvasculature and retinal nerve fiber layer (RNFL) changes using optical coherence tomography angiography (OCTA).

Methods: This was a retrospectively study and the medical records of 37 patients diagnosed with iERM or iMH underwent PPV with ILM peeling were retrospectively reviewed. Patients were divided into two groups according to different surgical conditions. Peripapillary OCTA images were acquired at pre-operation, 1 week, 1 month, and 3 months post-operation. Best corrected visual acuity (BCVA) was recorded. Intraocular pressure (IOP) was measured with Goldman applanation tonometer. Fisher's exact test, the Mann-Whitney U test, t test, and repeated-measures analysis of variance (RM-ANOVA) were used to analyze our data.

Results: The primary metrics found was the radial peripapillary capillary (RPC) small vessel density. The RPC in the protective group was significantly increased compared with the control group after surgery. At 3 months after vitrectomy, the mean and superior quadrant peripapillary RNFL thickness in the protective group was significantly higher than those in the control group. BCVA was improved in both groups at 3 months after surgery. BCVA and IOP did not differ significantly between these two groups pre- and post-operation.

Conclusion: Vitrectomy with ILM peeling may cause peripapillary microvascular and RNFL damage. The application of a modified surgical conditions may do some help in the recovery of peripapillary blood flow and peripapillary RNFL thickness.

Background: Limited population-based data as well as proposed mechanisms of retinal ganglion cell (RGC) loss suggest autoimmune disease may be a risk factor for glaucoma, the leading cause of irreversible blindness worldwide. Though intraocular pressure (IOP) is the leading risk factor for glaucoma onset and progression, a subset of glaucoma referred to as normal tension glaucoma (NTG) may be more likely to be associated with IOP-independent mechanisms of RGC injury including those of an inflammatory or immune nature.

Methods: This retrospective case-control study enrolled 277 patients with NTG and the same number of age- and sex-matched controls to determine whether autoimmune disease diagnosis, treatment thereof, or relevant laboratory markers are associated with NTG.

Results: There was no significant difference between the two groups in frequency of autoimmune disease overall, autoimmune disease catagorized by mechanism or organ involvement, or individual autoimmune disease including psoriasis (6% vs. 5%), rheumatoid arthritis (5% vs. 4%), inflammatory bowel disease (2% vs. 3%), Sjögren's syndrome (1% vs. 1%), sarcoidosis (1% vs. 1%), autoimmune thyroiditis (1% vs. 0%), type 1 diabetes (1% vs. 0%), or systemic lupus erythematosus (1% vs. 0%). There was also no significant difference in laboratory values or treatment of identified autoimmune conditions.

Conclusions: Our study found no significant association between autoimmune disease and NTG, suggesting that other factors may play a more significant role in the pathogenesis of NTG.

Purpose: To investigate the long-term safety and efficacy of using keratorefractive lenticule extraction (KLEx)-derived corneal stromal lenticules preserved in nutrient capsules for the treatment of corneal diseases.

Setting: Eye and ENT Hospital of Fudan University.

Design: Observational study.

Methods: Ten eyes of 10 patients with corneal diseases (6 males, 4 females, age 38.10 ± 9.11 years, ) were treated with phototherapeutic keratectomy combined with epikeratophakia or intrastromal keratoplasty using KLEx-derived lenticules. Corneal stromal lenticules which used for transplantation was extracted from healthy myopia patients and stored in nutrient capsules at 4 °C for 28 days. Patients underwent slit-lamp microscopy, uncorrected and corrected distance visual acuity (CDVA), subjective refraction, corneal topography, and anterior segment optical coherence tomography evaluations preoperative and were followed-up at 1-week, 1-month, 3-months, and 1-year postoperatively.

Results: No complications occurred intra- or postoperatively. CDVA increased by at least two lines in seven eyes and by one line in one eye, while remaining unchanged in two eyes, by the final follow-up. There was no significant difference found in the comparison of each postoperative corneal thickness to preoperative measure. The lenticules maintained a good degree of transparency 1-year post-operatively and adhered closely to the adjacent tissue. Intraocular pressure remained stable from preoperatively to all points postoperatively. There was no significant difference in corneal endothelial cell density values between pre and all post-operative time points.

Conclusion: KLEx-derived corneal stromal lenticules preserved in nutrient capsules for up to 28 days can be safely and effectively utilized as allografts for the treatment of corneal diseases, demonstrating favorable long-term outcomes.