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Refractive lens exchange in modern practice: when and when not to do it?

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Eye and Vision 2014年第1期1卷 59-71页

作者： Jorge L Alió andrzej grzybowski Dorota Romaniuk Vissum Corporation AlicanteSpain Division of Ophthalmology Universidad Miguel HernándezAlicanteSpain Department of Ophthalmology Poznan City HospitalPoznańPoland Chair of Ophthalmology University of Warmia and MazuryOlsztynPoland Clinical Department of Ophthalmology Silesian University of MedicineKatowicePoland Avda de Denia s/n Edificio Vissum03016 AlicanteSpain

Cataract surgery due to advances in small incision surgery evolved from a procedure concerned with the primary focus on the safe removal of cataractous lens to a procedure focused on the best possible postoperative refractive *** the outcomes of cataract surgery became better,the use of lens surgery as a refractive modality in patients without cataracts has increased in interest and in *** of the crystalline lens for refractive purposes or refractive lens exchange(RLE)presents several advantages over corneal refractive *** with high degrees of myopia,hyperopia and astigmatism are still not good candidates for laser ***,presbyopia can currently only be corrected with monovision or reading *** supplemented with multifocal or accommodating intraocular lenses(IOLs)in combination with corneal astigmatic procedures might address all refractive errors including presbyopia,and eliminate the future need for cataract surgery.

关键词： Refractive lens exchange Clear lens exchange Refractive surgery Lens surgery Ophthalmology Eye surgery

Long-term follow-up of cataract surgery in eyes filled with silicone oil

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International Journal of Ophthalmology(English edition) 2021年第1期14卷 72-75页

作者： Piotr Kanclerz Christoph Leisser andrzej grzybowski Pawel Lipowski Hygeia Clinic Gdańsk 80-286Poland VIROS-Vienna Institute for Research in Ocular Surgery a Karl Landsteiner InstituteVienna 1140Austria Hanusch Hospital Vienna 1140Austria Department of Ophthalmology University of Warmia and MazuryOlsztyn 10-082Poland Institute for Research in Ophthalmology Foundation for Ophthalmology DevelopmentPoznan 60-554Poland Department of Ophthalmology Medical University of GdańskGdańsk 80-952Poland

AIM:To evaluate the refractive and long-term outcome of eyes filled with silicone oil(SO)undergoing phacoemulsification cataract surgery(PCS).METHODS:This retrospective study evaluated patients with SO tamponade who were scheduled for ***:Subjects(n=26)were followed for 29.5±13.9 mo after cataract *** median spherical equivalent refraction(SER)was+5.3 D[interquartile range(IQR)+2.9 to+6.7]before PCS,and+3.4 D(IQR+2.0 to+4.4)after *** the follow-up period retinal reattachment after SO removal was achieved in 15 out of 26 eyes(57.7%).In 13 eyes assessment of refraction after SO-removal was possible,and showed a myopic shift of-4.6 D(IQR-2.9 to-7.3)in the *** SO removal,5 of the 13 eyes(38.5%)were within±1.0 D of the target refraction,while 9 out of the 13 eyes(69.2%)were within±2.0 ***:In our study,the refraction after PCS for eyes filled with SO manifested low predictability,as did the myopic shift following SO removal.A significant percentage of the eyes that underwent SO administration required a long-term tamponade.

关键词： biometry cataract surgery intraocular lens outcomes phacoemulsification refraction silicone oil

Crossover to PDT after the unsuccessful micropulse laser treatment of central serous chorioretinopathy

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Advances in Ophthalmology Practice and Research 2024年第1期4卷 32-38页

作者： Maciej Gawęcki Krzysztof Kicinski andrzej grzybowski Dobry Wzrok Ophthalmological Clinic 80-822GdanskPoland Department of Ophthalmology Pomeranian Hospitals in Wejherowo84-200WejherowoPoland Institute for Research in Ophthalmology Foundation for Ophthalmology DevelopmentPoznanPoland

Purpose:Subthreshold micropulse laser(SML)and photodynamic therapy(PDT)are among the most effective therapeutic modalities applied to central serous chorioretinopathy(CSCR).This study aimed to evaluate the ef-ficacy and durability of PDT in CSCR cases unresponsive to at least two SML ***:The study included 26 consecutive eyes of 24 patients(21 males and three females)with chronic *** all cases,a lack of reduction in subretinal fluid(SRF)levels was noted after at least two consecutive SML *** parameters of best corrected visual acuity(BCVA)and spectral domain optical coherence tomog-raphy(SD-OCT)were evaluated at baseline and 1,3 and 12 months ***:The mean duration of symptoms in the group was 53.81±39.48 months,the mean age of the patients was 49.26±12.91 years,and the mean subfoveal choroidal thickness(SFCT)was 572.11±116.21 *** resorption of SRF was observed in 21 out of 26 eyes(80.77%)at 1 month and sustained in 18 cases(69.23%)at 12 *** 12 months,in the sustained group,BCVA improved significantly from 0.39±0.18 to 0.19±0.2 logMAR(P=0.01),central subfoveal thickness(CST)reduced from 316.44±75.83 mm to 197.67±22.99 mm(P<0.0001),and SFCT reduced from 579.28 mm to 446.78 mm(P<0.0001).Conclusions:PDT provides the opportunity for the successful treatment of CSCR unresponsive to SML *** are possible even in cases with a long duration of symptoms and significant alterations in retinal ***,PDT should be considered for patients with prominently increased choroidal thickness.

关键词： Photodynamic therapy Subthreshold micropulse laser Central serous chorioretinopathy Sybretinal fluid

Microbial contamination of multiple-dose preservative-free hospital ophthalmic preparations in a tertiary care hospital

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Advances in Ophthalmology Practice and Research 2022年第1期2卷 42-48页

作者： Somporn Chantra Pinyada Hathaisaard andrzej grzybowski Paisan Ruamviboonsuk Department of Ophthalmology Rajavithi HospitalCollege of MedicineRangsit UniversityThailand University of Warmia and Mazury OlsztynPoland Institute for Research in Ophthalmology PoznanPoland

Background:It is possible that preservative-free eye drops can be *** aim of this study was to assess the incidence of microbial contamination of preservative-free hospital-prepared anti-infective eye drops and investigate factors that contribute to *** finding may help to raise awareness of this problem to medical healthcare staff and patients in order to prevent the transmission of microorganisms from eye drops to the patients through treatment of pre-existing eye ***:Two hundred and ninety-five eye drop bottles were collected from patients attending Rajavithi Hospital Ophthalmologic outpatient and inpatient department,including both those used by patients at home and those administered in the hospital by medical *** were taken from the tips of droppers and bottles,and the residual fluid inside the bottles was then cultivated onto different culture *** culture results were identified and analyzed according to various factors related to both individual users and the ***:Seven different types of eye drops were collected and 71(24.06%)of the 295 bottles were *** eye drops were the most ***-six different types of pathogens were identified,most frequently mold(42.98%),and the amount of contamination was higher in tips than in residual fluid inside the *** was no statistically significant difference in contamination between patients used eye drops collected in outpatient units(32.14%)and medical staff used eye drops collected in inpatient settings(23.22%).The only factor that was statistically significant was the number of eye drops used per *** found that samples from patients who used only up to 2 eye drops suffered contamination(42.8%)more than those from their counterparts who used at least 3(22.18%),P¼***:Of these preservative-free hospital preparations anti-infective eye drops,24.06%were *** number of eye drops used per

关键词： Microbial contamination Multiple-dose eye drops Anti-infective eye drops Preservative-free Hospital ophthalmic preparation

Image registration of the human accommodating eye demonstrates equivalent increases in lens equatorial radius and central thickness

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International Journal of Ophthalmology(English edition) 2019年第11期12卷 1751-1757页

作者： andrzej grzybowski Ronald A Schachar Magdalena Gaca-Wysocka Ira H Schachar Barbara KPierscionek Institute for Research in Ophthalmology Poznan 60-554Poland Department of Ophthalmology University of Warmia and MazuryOlsztyn 10-082Poland Department of Physics University of Texas in ArlingtonArlingtonTexas 76019USA Department of Ophthalmology Horngren Family Vitreoretinal CenterByers Eye InstituteStanford University School of MedicinePalo AltoCalifornia 94304USA School of Science and Technology Nottingham Trent UniversityNottingham NG14FQUK

AIM: To compare the results of in vivo human high resolution image registration studies of the eye during accommodation to the predictions of mathematical and finite element models of accommodation. METHODS: Data from published high quality image registration studies of pilocarpine induced accommodative changes of equatorial lens radius(ELR) and central lens thickness(CLT) were statistically analyzed. RESULTS: The mean changes in ELR and CLT were 6.76 μm/diopter and 6.51 μm/diopter, respectively. The linear regressions, reflecting the association between ELR and accommodative amplitude(AAELR) was: slope=6.58 μm/diopter, r^2=0.98, P<0.0001 and between CLT and AACLT was: slope=6.75 μm/diopter, r^2=0.83, P<0.001. On the basis of these relationships, the CLT slope and the AAELR were used to predict the measured change in ELR(ELRpredicted). There was no statistical difference between ELRpredicted and the measured ELR as demonstrated by a Student's paired t-test: P=0.96 and linear regression analysis: slope=0.97, r^2=0.98, P<***: Image registration with invariant positional references demonstrates that ELR and CLT equivalently minimally increase ~7.0 μm/diopter during accommodation. The small equivalent increases in ELRand CLT are associated with a large accommodative amplitude. These findings are consistent with the predictions of mathematical and finite element models that specified the stiffness of the lens nucleus is the same or greater than the lens cortex and that accommodation involves a small force(<5 g).

关键词： image registration accommodation equatorial lens radius central lens thickness

Patient reported outcomes after implementation of an enhanced depth of focus intraocular lens with low postoperative myopia

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Advances in Ophthalmology Practice and Research 2023年第2期3卷 86-92页

作者： Maciej Gawecki Natalia Pradzynska Krzysztof Kicinski Agnieszka Ratajczak Izabella Karska-Basta andrzej grzybowski Department of Ophthalmology of Specialist Hospital in Chojnice LesnaChojnicePoland Dobry Wzrok Ophthalmological Clinic Zabi KrukGdanskPoland Department of Ophthalmology Faculty of MedicineClinic of Ophthalmology and Ocular OncologyJagiellonian University Medical CollegeSwietej AnnyKrakowPoland Department of Ophthalmology University of Warmia and MazuryOczapowskiegoOlsztynPoland Institute for Research in Ophthalmology Foundation for Ophthalmology DevelopmentMickiewiczaPoznanPoland

Background:Enhanced depth-of-focus intraocular lenses(EDOF IOL)have filled the gap between monofocal and multifocal intraocular implants with optical qualities of monofocal lenses and usually minor dysphotopsias typical for multifocal *** purpose of this study was to evaluate visual outcomes after bilateral implantation of a new EDOF IOL in patients with requirements for perfect near and intermediate ***:The study included 15 patients(29 eyes as one was amblyopic)with bilateral implantation of LUXSMART EDOF IOL(Bausch&Lomb)with a targeted myopia(between-0.25 and-0.50D)in both *** corrected and uncorrected visual acuity for far,intermediate and near as well as refractive outcomes were evaluated at 1,3,6 and 12 months after the ***,binocular visual acuity,contrast sensitivity and defocus curve were measured at the final follow-up *** 12 months’visit patients completed a questionnaire evaluating patient satisfaction,spectacle independence and presence of ***:Binocular uncorrected visual acuities at 12 month’s visit were 0.13±0.16,0.06±0.08,0.07±0.09 and 0.15±0.09 logMAR for far distance,80 cm,66 cm and 40 cm *** binocular visual acuities at 12 months were 0.00±0.00,0.05±0.07,0.05±0.06,0.13±0.16 respectively for distance,80 cm,66 cm and 40 *** refraction spherical equivalent at 12 months’visit stood at-0.70±0.48D,which was 0.46D less than calculated biometric target,however spherical equivalent of subjective refraction at 12 months equaled–0.49±0.46D,which was closer to preoperative biometric *** curve had gentle shape without peaks typical for monofocal *** contrast sensitivity results were superior to average results for that age group and equaled 1.78±0.16 logMAR without correction and 1.81±0.13 logMAR with *** independence for near and intermediate distances was achieved in all patients and for far distance in 73.3%of ***

关键词： Enhanced depth of focus Intraocular lens Uncorrected visual acuity Cataract surgery

Drug-eluting intraocular lens with sustained bromfenac release for conquering posterior capsular opacification

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Bioactive Materials 2022年第3期7卷 343-357页

作者： Xiaobo Zhang Kairan Lai Su Li Jing Wang Jiayong Li Wei Wang Shuang Ni Bing Lu andrzej grzybowski Jian Ji Haijie Han Ke Yao Eye Center Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouPR China Zhejiang Provincial Key Laboratory of Ophthalmology HangzhouPR China Department of Ophthalmology University of Warmia and Mazury60-554 OlsztynPoland Institute for Research in Ophthalmology Gorczyczewskiego 2/361-553 PoznanPoland MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education Department of Polymer Science and EngineeringZhejiang UniversityHangzhouPR China

Cataract is the leading cause of visual impairment,and posterior capsular opacification(PCO)is the most common long-term complication of modern cataract surgery,which can cause severe visual impairment after *** proliferation,migration,and epithelial-mesenchymal transition(EMT)of residual lens epithelial cells(LECs)stimulated by growth factors and cytokines,are the key pathological mechanisms involved in the development of *** study demonstrated that non-steroidal anti-inflammatory drug(NSAID),bromfenac,was capable of effectively inhibiting cell migration,overexpression of EMT markers,such as fibronectin(FN),matrix metalloproteinase 2(MMP2),α-smooth muscle actin(α-SMA),and transcription factor Snail,and extracellular signal-regulated kinase(ERK)/glycogen synthase kinase-3β(GSK-3β)signaling induced by transforming growth factor-β2(TGF-β2)in *** inhibitory effect of bromfenac on TGF-β2-induced EMT was also verified on a primary lens epithelial cell model using human anterior ***,based on ultrasonic spray technology,we developed a drug-eluting intraocular lens(IOL)using poly(lactic-co-glycolic acid)(PLGA)with sustained bromfenac release ability for the prevention of PCO *** the rabbit models of cataract surgery,bromfenac-eluting IOL exhibited remarkable PCO prevention and inflammation suppression effects with excellent *** conclusion,bromfenac can inhibit TGF-β2-induced cell migration and the EMT of LECs via ERK/GSK-3β/Snail *** present study offers a novel approach for preventing PCO through PLGA-based drug sustained-release IOLs.

关键词： Posterior capsular opacification Drug-eluting IOLs Bromfenac ERK pathway Transcription factor Snail

Review Integration of smartphone technology and artificial intelligence for advanced ophthalmic care:A systematic review

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Advances in Ophthalmology Practice and Research 2024年第3期4卷 120-127页

作者： Kai Jin Yingyu Li Hongkang Wu Yih Chung Tham Victor Koh Yitian Zhao Ryo Kawasaki andrzej grzybowski Juan Ye Eye Center The Second Affiliated Hospital of Zhejiang University School of MedicineZhejiang Provincial Key Laboratory of OphthalmologyZhejiang Provincial Clinical Research Center for Eye DiseasesZhejiang Provincial Engineering Institute on Eye DiseasesHangzhouChina Centre for Innovation and Precision Eye Health National University of SingaporeSingapore Department of Ophthalmology National University of SingaporeSingapore Singapore Eye Research Institute Singapore National Eye CentreSingapore Ophthalmology and Visual Science Academic Clinical Program Duke-NUS Medical SchoolSingapore Cixi Institute of Biomedical Engineering Ningbo Institute of Materials Technology and EngineeringChinese Academy of SciencesNingboChina Ningbo Eye Hospital NingboChina Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology Ningbo Institute of Materials Technology and EngineeringChinese Academy of SciencesNingboChina Zhejiang Engineering Research Center for Biomedical Materials Ningbo Institute of Materials Technology and EngineeringChinese Academy of SciencesNingboChina Division of Public Health Department of Social MedicineGraduate School of MedicineOsaka UniversityOsakaJapan Artificial Intelligence Center for Medical Research and Application Osaka University HospitalOsakaJapan Institute for Research in Ophthalmology Foundation for Ophthalmology DevelopmentPoznanPoland

Background:The convergence of smartphone technology and artificial intelligence(AI)has revolutionized the landscape of ophthalmic care,offering unprecedented opportunities for diagnosis,monitoring,and management of ocular ***,there is a lack of systematic studies on discussing the integration of smart-phone and AI in this *** text:This review includes 52 studies,and explores the integration of smartphones and AI in ophthalmology,delineating its collective impact on screening methodologies,disease detection,telemedicine initiatives,and patient *** collective findings from the curated studies indicate promising performance of the smartphone-based AI screening for various ocular diseases which encompass major retinal diseases,glaucoma,cataract,visual impairment in children and ocular surface ***,the utilization of smartphone-based imaging modalities,coupled with AI algorithms,is able to provide timely,efficient and cost-effective screening for ocular *** modality can also facilitate patient self-monitoring,remote patient monitoring and enhancing accessibility to eye care services,particularly in underserved *** involving data pri-vacy,algorithm validation,regulatory frameworks and issues of trust are still need to be ***,evaluation on real-world implementation is imperative as well,and real-world prospective studies are currently ***:Smartphone ocular imaging merged with AI enables earlier,precise diagnoses,personalized treat-ments,and enhanced service accessibility in eye *** is crucial to navigate ethical and data security challenges while responsibly leveraging these innovations,promising a potential revolution in care access and global eye health equity.

关键词： Artificial intelligence Smartphone imaging Ophthalmology Telemedicine Ocular disease management

Image registration:Required for all ophthalmic imaging as demonstrated by optoretinography

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Advances in Ophthalmology Practice and Research 2023年第2期3卷 101-102页

作者： Ronald A.Schachar Ira H.Schachar andrzej grzybowski Department of Physics University of Texas at ArlingtonArlingtonTXUSA North Bay Vitreoretinal Consultants Santa RosaCAUSA Ophthalmology University of Warmia and MazuryOlsztynPoland Institute for Research in Ophthalmology Foundation for Ophthalmology DevelopmentPoznanPoland

*** Ophthalmology focuses on relating structural changes to function and *** biomicroscopy,ophthalmoscopy and fundus photography,to electroretinography and visual evoked potentials the clinical purpose is to objectively assess visual ***,these techniques are macroscopic and only grossly related to visual *** the development of optical coherence tomography(OCT)in vivo histological resolution of the retina has become routine.

关键词： function. visual Image