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Impact of multifocal gas-permeable lens designs on short-term choroidal response, axial length, and retinal defocus profile

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International Journal of Ophthalmology(English edition) 2024年第2期17卷 247-256页

作者： Muteb Alanazi Patrick Caroline Amane Alshamrani Maria Liu Optometry Department College of Applied Medical SciencesKing Saud UniversityRiyadh 14813Saudi Arabia College of Optometry Pacific UniversityForest GroveOregon 97116-1756United States Optometry School University of California at BerkeleyCalifornia 94720United States

AIM:To investigate the impact of multifocal gas permeable contact lens(MFGPCL)in various add power and distance/near area allocation on short-term changes of choroidal thickness(ChT),axial length(AL),and retinal defocus profile in young adults.METHODS:Seventeen young adults(2 males and 15 females;age 23.17±4.48y)were randomly assigned to wear two designs binocularly with a one-week washout period in between.Total of four MFGPCL designs were assessed.All designs were distance-center that varied in two add power(+1.50 and 3.00 D)and/or two distance zone(DZ)diameters(1.50 and 3.00 mm;design A:DZ 1.5/add 3.0,B:DZ 1.5/add 1.5,C:DZ 3.0/add 3.0,D:DZ 3.0/add 1.5).ChT,AL,and peripheral refraction data were collected on each subject at baseline,on days 1 and 7 of MFGPCL daily wear.ChT was assessed in four quadrants using a spectraldomain optical coherence tomography.RESULTS:AL was shortened by-26±44μm with lens C,-18±27μm with lens D,-13±29μm with lens A,and-8±30μm with lens B(all P<0.05).A significant overall increase in ChT was observed with all 4 designs(lens A:+6±6μm,B:+3±7μm,C:+8±7μm,and D:+8±7μm).Temporal and superior choroid exhibited more choroidal thickening associated with MFGPCL.All designs induced significant relative peripheral myopia(RPM)beyond the central 20o across the horizontal meridian in both nasal and temporal fields(P<0.05).CONCLUSION:MFGPCLs show a significant influence on ChT and AL,which are associated with significant increase in RPM after short-term wear.The reliability and feasibility of quantifying short-term changes in ChT support its use as a promising marker for the long-term efficacy of myopia-controlling treatments.

关键词： choroid gas-permeable contact lens retinal defocus axial length myopia

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axial length,vitreoretinal pathology,and anterior chamber depth can predict postoperative refractive outcomes in phacovitrectomy/silicone oil removal

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International Journal of Ophthalmology(English edition) 2023年第4期16卷 554-562页

作者： Xu Chen He Zhao Jia-Yun Ren Lu Wang Jun-Li Wan Bo Liu Nan Wu Xi Liu Yong Liu Southwest Hospital/Southwest Eye Hospital Army Medical UniversityChongqing 400038China Key Lab of Visual Damage and Regeneration&Restoration of Chongqing Chongqing 400038China

AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.METHODS:The study is a retrospective,case-series study.Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled.Eligible individuals were separated into four groups according to their preoperative diagnoses:silicone oil-filled eyes after PPV(group 1),epiretinal membrane(group 2),macular hole(group 3),and primary retinal detachment(RD;group 4).The variables af fecting postoperative refractive outcomes were analyzed,including age,gender,preoperative best-corrected visual acuity(BCVA),axial length(AL),keratometry average,anterior chamber depth(ACD),intraocular tamponade,and vitreoretinal pathology.The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within±0.50 diopter(D)and±1.00 D.RESULTS:For all patients,the mean PE was-0.04±1.17 D,and 50.17%of patients(eyes)had a PE within±0.50 D.There was a significant difference in refractive outcomes among the four groups(P=0.028),with RD(group 4)showing the least favorable refractive outcome.In multivariate regression analysis,only AL,vitreoretinal pathology,and ACD were strongly associated with PE(all P26 mm)and a deeper ACD were correlated with hyperopic PE,and shorter eyes(AL<26 mm)and a shallower ACD were correlated with myopic PE.CONCLUSION:RD patients have the least favorable refractive outcome.AL,vitreoretinal pathology,and ACD are strongly associated with PE in the combined surgery.These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.

关键词： axial length vitreoretinal pathology anterior chamber depth intraocular lens pars plana vitrectomy silicone oil removal cataract combined surgery refractive error intraocular tamponade

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axial length and anterior chamber indices in elderly population: Tehran Geriatric Eye Study

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International Journal of Ophthalmology(English edition) 2023年第11期16卷 1876-1882页

作者： Hassan Hashemi Samira Heydarian Alireza Hashemi Mehdi Khabazkhoob Noor Research Center for Ophthalmic Epidemiology Noor Eye HospitalTehran ***Iran Department of Rehabilitation Science School of Allied Medical SciencesMazandaran University of Medical SciencesSari ***Iran Noor Ophthalmology Research Center Noor Eye HospitalTehran ***Iran Department of Basic Sciences School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehran ***Iran

AIM:To determine the normative distribution of axial length(AL),anterior chamber depth(ACD),anterior chamber volume(ACV),anterior chamber angle(ACA),and some of their associated factors in subjects aged 60 and over.METHODS:In this cross-sectional study,160 clusters were sampled using multi-stage cluster sampling in Tehran,Iran.After a preliminary interview,the participants underwent optometric examinations including visual acuity and refraction measurement followed by slit lamp biomicroscopy.Finally,ocular imaging was done using the Pentacam AXL to measure AL,ACD,ACV,and ACA.RESULTS:A total of 4519 eyes of 2436 participants were evaluated,of whom 58.0%(n=1412)were female.The mean age of the subjects was 67.32±6.05y(range:60-95y).The mean AL,ACD,ACV,and ACA was 23.22 mm(23.18-23.27 mm),2.61 mm(2.59-2.62 mm),126.56 mm3(125.08-128.04 mm3),and 30.61°(30.3°-30.92°),respectively.In the multivariable model,after adjusting for the effect of both eyes,the longest and shortest AL was seen in myopic and hyperopic subjects,respectively.AL,ACD,ACV and ACA were significantly larger in men compared to women(P<0.001).Except ACA,other evaluated parameters showed an inverse correlation with age(P<0.001),however,this correlation was insignificant for AL(P=0.623).CONCLUSION:Normative value of AL,and other biometric parameters are specific for each ethnicity,age and sex group.Any alteration in these parameters and their effect on refraction should be considered in this age group,especially in case of cataract surgery.

关键词： biometry elderly axial length anterior chamber depth

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Changes in axial length after vitrectomy for rhegmatogenous retinal detachment combined with choroidal detachment

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International Journal of Ophthalmology(English edition) 2022年第8期15卷 1290-1295页

作者： Ji-Peng Li Jun Xu Meng Zhao Beijing Tongren Eye Center Beijing Key Laboratory of Ophthalmology and Visual ScienceBeijing Tongren HospitalCapital Medical UniversityBeijing 100730China

AIM:To report the postoperative axial length(AL)changes in rhegmatogenous retinal detachment combined with choroidal detachment(RRD-CD)patients.METHODS:The medical records of 97 consecutive patients from January 2015 to December 2018 were reviewed.Patients included were divided into RRD-CD and RRD only groups.All patients had received AL measurements before pars plana vitrectomy(PPV)and before silicone oil removal(SOR).The changes in AL of the two groups were compared.In addition,the potential factors related to AL changes were analyzed.RESULTS:AL elongation after PPV was 1.01 mm[interquartile range(IQR):0.37,1.79;P=0.02]in the RRD-CD group,which was greater than in RRD only group(0.15 mm,IQR:0.04,0.41;P<0.001).AL increased 0.06 mm per 1 mm Hg intraocular pressure changes in the RRD-CD group(R2=0.11,P=0.03).RRD-CD patient was 11.42 times(3.54-46.80)more likely to experience post-PPV AL elongation of more than 1 mm[P<0.001,Akaike information criterion(AIC)=92.33,area under the curve(AUC)=0.839].CONCLUSION:RRD-CD patients are very likely to have a postoperative elongation of AL.The primary intraoclular lens implantation using presurgery AL data may cause a significant refractive error in RRD-CD patients who underwent PPV.

关键词： rhegmatogenous retinal detachment choroidal detachment axial length pars plana vitrectomy

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Insight into small eyes: a practical description from phenotypes presentations to the management

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International Journal of Ophthalmology(English edition) 2024年第2期17卷 380-391页

作者： Sana Niazi Sorcha NíDhubhghaill Farideh Doroodgar Zisis Gatzioufas Mohammad Hossein Dehghan Translational Ophthalmology Research Center Tehran University of Medical SciencesTehran ***Iran Antwerp University Hospital Edegem 2650Belgium Faculty of Health Sciences Antwerp UniversityAntwerpen 2000EdegemBelgium Negah Aref Ophthalmic Research Center Shahid Beheshti University of Medical SciencesTehran 16666Iran University Eye Hospital Basel Basel 4031Switzerland

This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthalmos,relative anterior microphthalmos,and nanophthalmos,the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra-and post-operative complications.In this article,we review the criteria by which we recognize and describe pre-,intra-,and post-operative considerations,as well as discuss the ideal intraocular lenses for microphthalmos,given the intricate varieties of small eye phenotypes.

关键词： microphthalmos nanophthalmos lenses intraocular anterior chamber axial length eye cataract microcornea syndrome

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Association between axial length and toric intraocular lens rotation according to an online toric back-calculator

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International Journal of Ophthalmology(English edition) 2022年第3期15卷 420-425页

作者： Jennifer L.Patnaik Malik Y.Kahook John P.Berdahl David R.Hardten Brandie D.Wagner Leonard K.Seibold Brent A.Kramer Department of Ophthalmology University of Colorado School of MedicineAuroraColorado 80045USA Vance Thompson Vision Sioux FallsSouth Dakota 57108USA Minnesota Eye Consultants MinneapolisMinnesota 55404USA Department of Biostatistics Colorado School of Public HealthAuroraColorado 80045USA Department of Ophthalmology University of North CarolinaChapel HillNorth Carolina 27517USA

AIM: To assess the relationship between axial length(AL) and intraocular lens(IOL) rotation among eyes receiving a toric IOL and subsequently entered into an online toric back-calculator database.METHODS: Retrospective analysis of data collected online via ***, a freely available online toric back-calculator where surgeons enter pre-and postoperative information to help manage residual postoperative astigmatism.Included records were deemed valid with entry of AL and IOL orientation between January 2017 and March 2019.Rotation was determined by a difference of ≥5° between pre-operative intended IOL orientation and actual post-operative IOL orientation.Frequency and magnitude of rotation are presented with means and associated standard deviation(SD).Linear regression models of this association are presented.RESULTS: Records of 6752 eyes were included in the analysis, of which 74.8% were determined to have a rotated IOL.The magnitude of rotation increased with each millimeter(mm) increase in AL with a mean rotation of 13.3°(SD: 12.8°) for eyes with AL 20-20.9 mm and a maximum mean rotation of 30.6°(SD: 30.3°) among eyes with AL 29-29.9 mm.General linear modeling demonstrated a significant association(P<0.0001) with a parameter estimate of 1.19(standard error: 0.159) and R;of 0.0083.CONCLUSION: Analysis from an online database indicates that toric IOLs inserted into eyes with longer AL are more likely to rotate and to rotate more degrees from the target axis.The findings from this study are clinically relevant for surgeons implanting toric IOLs.

关键词： cataract surgery toric lens axial length rotation

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Distribution and correlation of refractive parameters in children with different corneal curvatures in southeast China

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International Journal of Ophthalmology(English edition) 2024年第4期17卷 713-720页

作者： Si-Yuan He Ting He Meng-Yue Xu Ying-Jie Ni Chao-Yang Hong Ting Shen The Second Clinical College Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Ophthalmology Zhejiang Provincial People’s HospitalAffiliated People’s HospitalHangzhou Medical CollegeHangzhou 310014Zhejiang ProvinceChina Eye Center the Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009Zhejiang ProvinceChina

AIM:To analyze the distribution of refractive status in school-age children with different corneal curvatures(CC)and the correlation between CC and refractive status.METHODS:A total of 2214 school-aged children of grade 4 in Hangzhou who were screened for school myopia were included.Uncorrected distance visual acuity(UCDVA),non-cycloplegic refraction,axial length(AL),horizontal and vertical corneal curvature(K1,K2)were measured and spherical equivalent(SE),corneal curvature radius(CCR)and axial length/corneal radius of curvature ratio(AL/CR)were calculated.UCDVA<5.0 and SE≤-0.50 D were classified as school-screening myopia.According to the different CCRs,the patients were divided into the lower corneal curvature(LCC)group(CCR≥7.92)and the higher corneal curvature(HCC)group(CCR<7.92).Each group was further divided into the normal AL subgroup and the long AL subgroup.The refractive parameters were compared to identify any differences between the two groups.RESULTS:Both SE and AL were greater in the LCC group(P=0.013,P<0.001).The prevalence of myopia was 38% in the LCC group and 44% in the HCC group(P<0.001).The proportion of children without screening myopia was higher in the LCC group(62%)than in the HCC group(56%).Among these children without screening myopia,the proportion of long AL in the LCC group(24%)was significantly higher than that in the HCC group(0.012%;P<0.001).The change of SE in the LCC group was less affected by the increase of AL than that in the HCC group.CONCLUSION:School-aged children in the LCC group have a lower incidence of screening myopia and longer AL.Low CC can mask SE reduction and AL growth to some extent,and the change of AL growth change more in children with low CC than high CC.Before the onset of myopia,its growth rate is even faster than that after the onset of myopia.

关键词： school-aged children corneal curvature axial length spherical equivalent myopia screening

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One-year results for myopia control of orthokeratology with different back optic zone diameters: a randomized trial using a novel multispectral-based topographer

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International Journal of Ophthalmology(English edition) 2024年第2期17卷 324-330页

作者： Wen-Ting Tang Xiang-Ning Luo Wen-Jing Zhao Jia Liao Xin-Yue Xu Hui-Dan Zhang Li Zhang Department of Ophthalmology the First Affiliated Hospital of Chengdu Medical CollegeChengdu Medical CollegeChengdu 610500Sichuan ProvinceChina

AIM:To present the 1-year results of a prospective cohort study investigating the efficacy,potential mechanism,and safety of orthokeratology(ortho-k)with different back optic zone diameters(BOZD)for myopia control in children.METHODS:This randomized clinical study was performed between Dec.2020 and Dec.2021.Participants were randomly assigned to three groups wearing ortho-k:5 mm BOZD(5-MM group),5.5 mm BOZD(5.5-MM group),and 6 mm BOZD(6-MM group).The 1-year data were recorded,including axial length,relative peripheral refraction(RPR,measured by multispectral refractive topography,MRT),and visual quality.The contrast sensitivity(CS)was evaluated by CSV-1000 instrument with spatial frequencies of 3,6,12,and 18 cycles/degree(c/d);the corneal higher-order aberrations(HOAs)were measured by iTrace aberration analyzer.The one-way ANOVA was performed to assess the differences between the three groups.The correlation between the change in AL and RPR was calculated by Pearson’s correlation coefficient.RESULTS:The 1-year results of 20,21,and 21 subjects in the 5-MM,5.5-MM,and 6-MM groups,respectively,were presented.There were no statistical differences in baseline age,sex,or ocular parameters between the three groups(all P>0.05).At the 1-year visit,the 5-MM group had lower axial elongation than the 6-MM group(0.07±0.09 vs 0.18±0.11 mm,P=0.001).The 5-MM group had more myopic total RPR(TRPR,P=0.014),with RPR in the 15°–30°(RPR 15–30,P=0.015),30°–45°(RPR 30–45,P=0.011),temporal(RPR-T,P=0.008),and nasal area(RPR-N,Paxial elongation and the change in TRPR(r=0.756,P<0.001),RPR 15–30(r=0.364,P=0.004),RPR 30–45(r=0.306,P=0.016),and RPR-N(r=0.253,P=0.047).The CS decreased at 3 c/d(P<0.001),and the corneal HOAs increased in the 5-MM group(P=0.030).CONCLUSION:Ortho-k with 5 mm BOZD can control myopia

关键词： relative peripheral refraction orthokeratology myopia back optic zone diameter axial length multispectral refractive topography

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Internal limiting membrane peeling combined with silicone oil or air tamponade for highly myopic foveoschisis

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International Journal of Ophthalmology(English edition) 2024年第6期17卷 1079-1085页

作者： Jin Deng Wen-Tao Sun Ke Gong Li-Ping Wang Feng-Zhi Li Xi’an People’s Hospital(Xi’an Fourth Hospital) Shaanxi Eye HospitalAffiliated People’s Hospital of Northwest UniversityXi’an 70004Shaanxi ProvinceChina

AIM:To compare the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)and silicone oil or sterile air tamponade for the treatment of myopic foveoschisis(MF)in highly myopic eyes.METHODS:This retrospective study included 48 myopic eyes of 40 patients with MF and axial lengths(ALs)ranging from 26-32 mm treated between January 2020 and January 2022.All patients were underwent PPV combined with ILM peeling followed by sterile air or silicone oil tamponade and followed up at least 12mo.Based on the features on spectral-domain optical coherence tomography(SD-OCT),the eyes were divided into the MF-only group(Group A,n=15 eyes),MF with central foveal detachment group(Group B,n=20 eyes),and MF with lamellar macular hole group(Group C,n=13 eyes).According to AL,eyes were further divided into three groups:Group D(26.01-28.00 mm,n=12 eyes),Group E(28.01-30.00 mm,n=26 eyes),and Group F(30.01-32.00 mm,n=10 eyes).The best-corrected visual acuity(BCVA),central foveal thickness(CFT),and complications were recorded.RESULTS:The patients included 16 males and 24 females with the mean age of 56±9.82y.The BCVA and CFT improved in all groups after surgery(P0.05).The intergroup differences of BCVA and CFT postoperatively were statistically significant in Group D,E,and F.Twenty eyes were injected with sterile air,and 28 eyes were injected with silicone oil for tamponade based on the AL.However,there was no statistically significant difference among Groups D,E,and F in terms of the results of sterile air or silicone oil tamponade.The mean recovery time was 5.9mo for MF patients subjected to silicone oil tamponade and 7.7mo for patients subjected to sterile air tamponade,and the difference was not statistically significant.CONCLUSION:PPV and ILM peeling combined with silicone oil or sterile air tamponade can achieve good results for MF in highly myopic eyes with ALs≤32 mm.

关键词： axial length myopic foveoschisis highly myopic internal limiting membrane pars plana vitrectomy

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Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation

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International Journal of Ophthalmology(English edition) 2022年第8期15卷 1322-1330页

作者： Meng-Jun Zhu Li Ding Lin-Lin Du Jun Chen Xian-Gui He Shan-Shan Li Hai-Dong Zou Shanghai Eye Disease Prevention&Treatment Center/Shanghai Eye Hospital Shanghai 200040China Shanghai General Hospital National Clinical Research Center for Eye DiseasesShanghai Key Laboratory of Ocular Fundus DiseasesShanghai Engineering Center for Visual Science and PhotomedicineShanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye DiseasesShanghai 200080China

AIM:To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology(ortho-k)over 1-year period and its effects on the axial elongation.METHODS:A total of 202 Chinese myopic children were enrolled in this prospective clinical trial.Ninetyfive subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study.axial length(AL)was measured before enrollment and every 6mo after the start of ortho-k.The photopic pupil diameter(PPD)was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx.Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation.RESULTS:Compared with spectacle group,the average 1-year axial elongation was significantly slower in the ortho-k group(0.25±0.27 vs 0.44±0.23 mm,P0.05,Bonferroni correction).The 4.81 mm PPD may be a possible cutoff point in the ortho-k group.Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period(t=-3.09,P=0.003).In ortho-k group,univariate analyses indicated that those with older age,greater degree of myopia,longer AL,smaller baseline PPD(PPDbaseline)experienced a smaller change in AL.In multivariate analyses,older age,greater AL and smaller PPDbaseline were associated with smaller increases in AL.In spectacle group,PPD tended to be stable(P>0.05,Bonferroni correction)and did not affect axial growth.CONCLUSION:PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment.Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.

关键词： orthokeratology myopia axial length pupil diameter accommodation

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