Journal of cataract and refractive surgery最新文献

{"title":"Evaluating the small aperture intraocular lens: depth of focus and the role of refraction and preoperative corneal astigmatism in visual performance.","authors":"John Vukich, Vance Thompson, Elizabeth Yeu, William F Wiley, Shamik Bafna, Douglas D Koch, Ling Lin, Magda Michna","doi":"10.1097/j.jcrs.0000000000001524","DOIUrl":"10.1097/j.jcrs.0000000000001524","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate depth of focus (DOF) and visual acuities (VAs) by manifest refractive spherical equivalent (MRSE) and degree of preoperative corneal astigmatism with the IC-8 small aperture intraocular lens (SA IOL) (Apthera).</p><p><strong>Setting: </strong>21 investigational sites in the United States.</p><p><strong>Design: </strong>Prospective, multicenter, open-label, parallel-group, nonrandomized, examiner-masked, 1-year clinical study.</p><p><strong>Methods: </strong>Included patients had cataract and ≤1.5 diopters (D) preoperative corneal astigmatism. Patients received either the SA IOL in 1 eye targeted to -0.75 D and a monofocal or monofocal toric IOL in the other targeted to plano (SA IOL group) or bilateral monofocal/monofocal toric IOLs targeted to plano (control group). Monocular and binocular assessments included defocus curves and uncorrected VAs (distance, intermediate, and near) by postoperative MRSE; monocular VAs were assessed by degree of preoperative corneal astigmatism.</p><p><strong>Results: </strong>The SA IOL group (n = 343) achieved 0.82 D additional binocular DOF vs the control group (n = 110), and SA IOL eyes achieved 0.91 D additional monocular DOF over fellow eyes. Across all MRSEs, the SA IOL group achieved monocular uncorrected VAs of 20/40 or better and binocular uncorrected VAs of 20/32 or better across all distances. In addition, SA IOL eyes with higher (1.0-1.5 D) vs lower (<1.0 D) preoperative corneal astigmatism achieved equivalent monocular uncorrected VAs.</p><p><strong>Conclusions: </strong>The SA IOL provides increased DOF vs monofocal/monofocal toric IOLs and consistent monocular and binocular vision across several postoperative MRSEs and up to 1.5 D of preoperative corneal astigmatism, giving patients with cataract and mild astigmatism the potential for an extended range of vision and reliable visual outcomes.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"1165-1172"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular dominance shift in refractive cataract surgery: prospective, observational study.","authors":"Tingting Song, Fen Nie, Yang Zhao, Menglian Liao, Lian He, Qiongyan Tang, Xuanchu Duan","doi":"10.1097/j.jcrs.0000000000001520","DOIUrl":"10.1097/j.jcrs.0000000000001520","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the features of the dominant and nondominant eyes in patients with cataracts and predict ocular dominance shift (ODS) based on preoperative indicators.</p><p><strong>Setting: </strong>Changsha Aier Eye Hospital, Changsha, Hunan, China.</p><p><strong>Design: </strong>Prospective, observational study.</p><p><strong>Methods: </strong>Patients with age-related cataracts who underwent unilateral cataract surgery were enrolled in this study. Before the procedure, uncorrected distance visual acuity (UDVA) was assessed and noncycloplegic subjective refraction evaluations were conducted to determine corrected distance visual acuity. Total astigmatism, corneal astigmatism, and intraocular astigmatism were measured using OPD-Scan III. Cataract type was assessed using slitlamp biomicroscopy based on the Lens Opacities Classification System III. Ocular dominance (OD) was determined under corrected conditions using the hole-in-card test. Follow-up visits occurred at 1 day, 1 week, and 1 month postoperatively. After 1 month, OD was re-evaluated, and participants completed the 9-item Short-Form Cataract Questionnaire.</p><p><strong>Results: </strong>94 patients (188 eyes) were enrolled in the study. The analysis showed that the ODS rate of unilateral cataract surgery was 40.4%. In addition, age, UDVA of the nondominant eye, posterior subcapsular cataract, and total astigmatism were risk factors for ODS. No difference in vision-related quality of life was detected between patients who had ODS and those who did not.</p><p><strong>Conclusions: </strong>Several preoperative parameters as potential risk factors of ODS after cataract surgery were identified. These findings provide guidance for predicting changes in the dominant eye and may improve the precise selection of intraocular lenses and implementation of monovision strategies.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"1135-1142"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Power profile and optical performance of two extended range-of-vision intraocular lens designs.","authors":"Fidel Vega, Nuria Garzón, María García-Montero, María S Millán","doi":"10.1097/j.jcrs.0000000000001528","DOIUrl":"10.1097/j.jcrs.0000000000001528","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the power profile and optical performance of 2 extended range-of-vision (ERV) intraocular lenses (IOLs), TECNIS Eyhance (ICB00) and LuxSmart, and compare them with their monofocal counterpart lenses with similar platforms and materials: TECNIS 1-piece (ZCB00) and LuxGood, respectively.</p><p><strong>Setting: </strong>Optics and Optometry Faculties of Complutense University (Madrid) and Universitat Politècnica de Catalunya BarcelonaTech (Terrassa) in Spain.</p><p><strong>Design: </strong>Laboratory investigation on optical bench.</p><p><strong>Methods: </strong>For each design, the power distribution and (fourth and sixth-order) spherical aberration (SA) across the lens aperture were measured as well as the optical performance using modulation transfer function-based metrics with through-focus evaluation. 3 nominal powers (+10.00 diopters [D], +20.00 D, and +30.00 D) and 3 pupil sizes (2.0 mm, 3.0 mm, and 4.5 mm) were considered to assess whether the base power of the lens and pupillary dynamics have an influence on the depth-of-focus extension.</p><p><strong>Results: </strong>TECNIS Eyhance and LuxSmart IOLs had different power and SA profiles, but both designs shared a positive add power in their central region in comparison with their monofocal counterparts. LuxSmart had a greater add power while TECNIS Eyhance showed higher peak optical quality but smaller depth of focus.</p><p><strong>Conclusions: </strong>Differences of focus extension between the 2 ERV IOL designs are related to differences of power and SA profile. The nominal base power of the IOLs has little effect on their optical quality. However, pupil dynamics plays a key role since it determines the effective add power and optical performance of the ERV IOLs.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"1065-1073"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural integrity of eyelets in a hydrophobic intraocular lens with four-point scleral fixation.","authors":"Zi Jin, André S Pollmann, R Rishi Gupta, Adrian T Fung","doi":"10.1097/j.jcrs.0000000000001527","DOIUrl":"10.1097/j.jcrs.0000000000001527","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"1092-1093"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of the relationship between the severity of posterior capsular opacification detected by objective detection techniques and visual acuity.","authors":"Ziyue Song, Zhigang Chen, Caixin Li, Yanting Li, Yueqi Liu, Peirong Lu","doi":"10.1097/j.jcrs.0000000000001494","DOIUrl":"10.1097/j.jcrs.0000000000001494","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the severity of posterior capsule opacification (PCO) using objective detection techniques and its relationship with visual acuity.</p><p><strong>Setting: </strong>The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>All patients underwent slitlamp examination, intraocular pressure (IOP) measurement, and corrected distance visual acuity (CDVA) testing before Nd:YAG laser capsulotomy, and examination, after fully dilated, with: IOLMaster 700, optical coherence tomography (OCT), Sirius Topographer (CSO) anterior segment analysis, and color fundus photography (CFP). CDVA and IOP were taken post treatment. Thickness and density of the posterior capsule, CFP quality (CFPQ) and OCT signal strength (OCTSS) were recorded. Analysis used Spearman correlation, heatmaps, and receiver operating characteristic curves.</p><p><strong>Results: </strong>83 eyes in 78 patients were included in this study. Spearman correlation analysis revealed correlations between pretreatment CDVA and IOLMaster 700 PCO thickness (MT), IOLMaster 700 cumulative effect (MCE), Sirius PCO thickness (ST), Sirius maximum density (SMD), Sirius cumulative effect (SCE), OCTSS, and CFPQ (correlation coefficients were 0.500, 0.484, 0.465, -0.256, 0.317, -0.442, -0.412, all P < .05). The improvement of vision acuity (ImpVA) showed correlations with MT, MCE, ST, SCE, OCTSS, and CFPQ (correlation coefficients were -0.452, -0.471, -0.346, -0.278, 0.320, 0.381, all P < .05). For ImpVA, the predictive ability of IOLMaster 700 was superior to Sirius, and the joint model was significantly better than single factors.</p><p><strong>Conclusions: </strong>Posterior capsule thickness and cumulative effect were reliable indicators for evaluating PCO. Compared with Sirius, the IOLMaster 700 demonstrated superior predictive ability and higher correlation.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"1020-1025"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of a novel crosslinked hyaluronate canalicular gel occlusive device for dry eye.","authors":"Mark Packer, Richard Lindstrom, Vance Thompson, Jai G Parekh, Preeya Gupta, Lisa M Nijm, Eric Donnenfeld","doi":"10.1097/j.jcrs.0000000000001505","DOIUrl":"10.1097/j.jcrs.0000000000001505","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness and safety of a crosslinked hyaluronate (HA) canalicular filler (Lacrifill Canalicular Gel) compared with a commercially available hydrogel canalicular plug (Form Fit).</p><p><strong>Setting: </strong>5 sites in the United States.</p><p><strong>Design: </strong>Prospective, multicenter, controlled, double-masked, randomized 2:1 (filler:plug).</p><p><strong>Methods: </strong>Adults (≥22 years) with the Schirmer test (with anesthesia) ≤10 mm/5 minutes, presence of corneal staining, ocular surface disease index (OSDI) of ≥23 with ≤3 responses of \"not applicable,\" patent lacrimal drainage system, and bilateral corrected distance visual acuity of 20/40 or better. Filler or plugs were instilled bilaterally in the inferior canaliculi. Primary effectiveness endpoint was noninferiority of the mean within subject change from baseline to month 3 in Schirmer score for patients receiving filler compared with plugs. The key secondary effectiveness endpoint was noninferiority of the proportion of patients with filler achieving improvement from baseline to month 3 in OSDI by a minimal clinically important difference. Additional endpoints included the mean change from baseline to 3 and 6 months in tear meniscus height, OSDI, corneal staining, tear breakup time, and safety.</p><p><strong>Results: </strong>157 patients were randomized; 99 patients with crosslinked HA filler and 52 patients with hydrogel plugs completed the study. Filler was noninferior to plugs in the mean Schirmer score change from baseline and in the proportion of patients achieving a clinically important improvement in OSDI.</p><p><strong>Conclusions: </strong>Crosslinked HA filler is a safe, well-tolerated, and effective method to treat dry eye. Clinically and statistically significant improvements in signs and symptoms of dry eye were sustained through 6 months.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"1051-1057"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reusing surgical materials for cataract surgery: an assessment of potential contamination.","authors":"Aakriti Garg Shukla, David F Chang, Thamizhselvi Dhanaseelan, Vellam Ramakrishnan Vivekanandan, Joseph Gubert, Alan L Robin, Rengaraj Venkatesh","doi":"10.1097/j.jcrs.0000000000001509","DOIUrl":"10.1097/j.jcrs.0000000000001509","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate microbiological cultures of cataract surgical devices and products that were reused for multiple cases.</p><p><strong>Setting: </strong>Aravind Eye Hospital, Pondicherry, Tamil Nadu, India.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>Samples from multiple surgical instruments and products that were reused for consecutive cataract surgeries underwent bacterial and fungal cultures and were monitored alongside positive controls for 7 days. This included instruments that were processed using immediate use steam sterilization (IUSS) between cases (eg, surgical cannulas, syringes, phacoemulsification and coaxial/bimanual irrigation/aspiration [I/A] tips, phacoemulsification and I/A sleeves) (Group 1), instruments that were used without sterilization between cases (eg, phacoemulsification tubing/handpieces, coaxial I/A handpieces) (Group 2), and the residual (unused) fluid from balanced salt solution bags after being used for multiple patients (Group 3).</p><p><strong>Results: </strong>3333 discrete samples were collected from all 3 product groups that were reused across multiple patients. In all collected samples, no bacterial or fungal growth was observed. Of the 3241 cataract surgeries that used reused and IUSS-sterilized instruments alongside instrument sets cultured on the same day and balanced salt solution bags shared across multiple patients, no eyes developed endophthalmitis over a 6-week follow-up period.</p><p><strong>Conclusions: </strong>Bacterial or fungal growth was not found in extensive microbiological cultures of IUSS-sterilized ophthalmic surgical instruments and cataract surgical products that were reused in multiple patients. This microbiological data complements clinical endophthalmitis data from 2 million consecutive cases at the Aravind Eye Hospital, suggesting that their instrument and surgical supply processing practices may allow for safe and sustainable ophthalmic care.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"993-999"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluorescein-conjugated hyaluronic acid enables visualization of retained ophthalmic viscosurgical device in anterior chamber.","authors":"Erick E Rocher, Allen O Eghrari","doi":"10.1097/j.jcrs.0000000000001503","DOIUrl":"10.1097/j.jcrs.0000000000001503","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and assess the utility of an ophthalmic viscosurgical device (OVD) manufactured with fluorescein-conjugated hyaluronic acid (conjHA).</p><p><strong>Setting: </strong>Department of Biomedical Engineering and the Wilmer Eye Institute, Johns Hopkins University and School of Medicine, Baltimore, Maryland.</p><p><strong>Design: </strong>Laboratory study.</p><p><strong>Methods: </strong>ConjHA and unconjugated HA (unconjHA) at varied ratios were used to produce OVD (conjOVD) with varied fluorescence intensity. The conjHA:unconjHA ratio was optimized to maximize clarity under white light and fluorescence intensity under cobalt blue light (CBL), allowing for conditional visualization. The effect of conjugation on conjOVD viscosity was assessed by rotational rheometry. Intraocular lenses (IOLs) were immersed in conjOVD for 4 hours to assess staining of IOLs. A proof-of-concept study was performed in ex vivo porcine eyes. After injection and visualization, the OVDs were removed from the eyes by irrigation/aspiration (I/A).</p><p><strong>Results: </strong>0.5 mg/mL of conjHA (degree of substitution = 0.005) enabled robust fluorescence of conjOVD under CBL. Fluorescein conjugation did not significantly affect conjOVD viscosity ( P > .05 for mean difference in viscosity at all shear rates tested). No staining of IOLs was appreciated. ConjOVD was visualized under CBL when injected ex vivo and maintained clarity of the anterior chamber under white light. Importantly, conjHA enabled delineation of retained OVD after I/A.</p><p><strong>Conclusions: </strong>Use of OVD composed of fluorescein-conjugated HA is a feasible method to enable conditional visualization of OVD intraoperatively without nonspecific staining of ocular structures. Further development of this technology may enable accelerated OVD removal in ocular surgery or decreased OVD retention postoperatively.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"1058-1064"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical nonsteroidal anti-inflammatory drugs for management of pain after PRK: systematic review and network meta-analysis.","authors":"Dror Ben Ephraim Noyman, Adir C Sommer, Efrat Naaman, Javier H Gonzalez-Lugo, Michael Mimouni","doi":"10.1097/j.jcrs.0000000000001525","DOIUrl":"10.1097/j.jcrs.0000000000001525","url":null,"abstract":"<p><strong>Topic: </strong>Topical nonsteroidal anti-inflammatory drugs (NSAIDs) for management of pain in patients after photorefractive keratectomy (PRK).</p><p><strong>Clinical relevance: </strong>Pain after PRK is a major concern for both patients and surgeons. Although evidence supports the use of NSAIDs postoperatively, no consensus exists regarding the preferred regimen. The study aimed to compare the efficacy and safety of different topical NSAIDs.</p><p><strong>Methods: </strong>This study was prospectively registered with PROSPERO (ID: CRD42023417651). A systematic search of electronic databases was performed, for randomized controlled trials reporting topical NSAIDs' outcomes of corneal re-epithelization, rescue analgesics intake, and pain in days 0 to 3 after PRK (postoperative days [PODs] 0 to 3). Studies were graded for risk of bias. Data were extracted, and standardized mean differences (SMDs) were evaluated in a network meta-analysis in accordance with the Cochrane's guidelines, to which a frequentist approach model was fitted. Transitivity was assessed using the net split method. Treatment effectiveness was ranked using forest plots based on comparison with placebo. P-scores (P) and league tables were used to examine combined direct and indirect comparisons.</p><p><strong>Results: </strong>Of 1540 studies identified, 27 were included. These encompassed 2286 patients across 11 countries, evaluating 7 distinct topical NSAIDs. At POD0, ketorolac (P 0.764), flurbiprofen (P 0.763), and bromfenac (P 0.717) were the most efficient drugs overall and displayed significantly lower pain scores than placebo. Other than that, flurbiprofen held the highest rank for reported pain throughout, significantly outperforming placebo on POD1 (P 0.874, SMD -1.19, 95% CI -1.86 to -0.52), POD2 (P 0.882, SMD -1.05, 95% CI -1.82 to -0.27), and POD3 (P 0.939, SMD -1.14, 95% CI -2.1 to -0.18). Other NSAIDs were significantly better than placebo only on POD1 and POD0. Rescue analgesic intake analysis favored indomethacin (P 0.834, SMD -0.8, 95% CI -1.33 to -0.27), ketorolac, and diclofenac. Compared with placebo, re-epithelization was slowed to different significances with all NSAIDs but flurbiprofen (P 0.991, SMD -0.7, 95% CI -1.38 to -0.03).</p><p><strong>Conclusions: </strong>Flurbiprofen was favorable in pain scores on typically painful postoperative days and re-epithelization times. However, analgesics intake, a more objective outcome, suggested superiority of other NSAIDs. Inconsistencies may be explained by the small sample size. For clinical interpretation, NSAID effect sizes should be taken into consideration.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"1083-1091"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in corneal endothelial cells after scleral-fixated intraocular lens surgery in children with congenital ectopia lentis: 2-year follow-up.","authors":"Siyuan Liu, Zhenzhen Liu, Zhangkai Lian, Charlotte Young, Xinyu Zhang, Danying Zheng, Guangming Jin","doi":"10.1097/j.jcrs.0000000000001499","DOIUrl":"10.1097/j.jcrs.0000000000001499","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the changing patterns of corneal endothelial cells and the associated factors in children with congenital ectopia lentis (CEL) after scleral-fixated intraocular lens (SF IOL) surgery.</p><p><strong>Setting: </strong>Zhongshan Ophthalmic Center, Guangzhou, China.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Patients were divided into the surgery group and the control group. Central endothelial cell density (ECD), coefficient of variation in cell size, the percentage of hexagonal cells (hexagonality), average cell size (AVG), and central corneal thickness were analyzed for both groups at baseline and each follow-up visit. Clinic characteristic, ocular parameters, IOL decentration, and IOL tilt of patients in the surgery group were collected. Multiple linear regression was performed to assess the potential associated factors for the postoperative changes in corneal endothelial cells in the surgery group.</p><p><strong>Results: </strong>After 2-year follow-up, the decline of ECD was 17.8% (95% CI, -21.8 to -13.9) in the surgery group and -3.1% (95% CI, -5.2 to -1.0) in the control group ( P < .001), while the increase of AVG was 24.3% (17.1-31.6) in the surgery group and 2.7% (1.0 to 4.5) in the control group ( P < .001). Multivariate analysis showed that axial length (AL) ≥24 mm and white-to-white (WTW) <12.2 mm were significantly associated with greater loss of ECD (β = -241.41, 95% CI, -457.91 to -24.91, P = .030 and β = 251.63, 95% CI, 42.10-461.17, P = .020, respectively) and AL ≥24 mm was significantly positively associated with the increase of AVG (β = 34.81, 95% CI, 0.90-68.71, P = .044).</p><p><strong>Conclusions: </strong>The SF IOL had a significant impact on corneal endothelium in children with CEL. More attention should be paid to monitor postoperative corneal endothelium change during long-term follow-up in CEL children, especially for those with longer AL and smaller WTW.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"1045-1050"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}