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China has recently proposed a countrywide myopia control strategy for children and adolescents due to the rapidly increasing incidence and early onset of myopia.Recent studies have proposed interventions and methods for myopia prevention and control, such as low-dose atropine and orthokeratology lens, while the current strategies are subject to cause inconvenience and ineligible risks of side effects.Although accumulating evidence has shown that increased time outdoors is effective in reducing the risk of myopia development, its effect is closely related to light exposure.Interventions to enhance time spent outdoors or further increase on light exposure to prevent myopia are pragmatically challenging.A multicenter randomized controlled trial (RCT) led by Zhongshan Ophthalmic Center, adopted repeated low-level red-light (RLRL) to deliver light on the retina directly for a much shorter duration of exposure but repeatedly, and further assessed the efficacy and safety of RLRL therapy in myopia control among children.Findings from the RCT showed promising efficacy of RLRL therapy in slowing myopia progression among school-age children with mild to moderate myopia, providing high-level evidence for RLRL therapy as a safe and efficacious strategy for reducing myopia progression.This paper summarized the findings from the RCT, discussed how to adopt such a treatment for myopia control in clinical practice, and further suggested eye care service providers to follow the research progress of RLRL therapy for myopia prevention and control.
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Objective:To evaluate the effectiveness and safety of transepithelial photorefractive keratectomy (TransPRK) assisted by smart pluse technology (SPT) for the correction of high myopia.Methods:An observational case series study was conducted.Sixty high myopic patients (107 eyes) with spherical equivalent (SE)≥-6.0 D who received TransPRK assisted by SPT from January to December 2016 in Eye Hospital of Wenzhou Medical University were enrolled.Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) of the patients were examined and recorded in logarithm of the minimum angle of resolution (LogMAR) units, and refraction was examined with a subjective refractometer.The healing of corneal epithelium and corneal haze was observed with a slit lamp.Intraocular pressure (IOP) was measured with the non-contact tonometer.Safety index (SI) and efficacy index (EI) were analyzed.The follow-up time was 12 months.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Eye Hospital of Wenzhou Medical University (No.2019-197-k-177). Written informed consent was obtained from each patient prior to any medical examination.Results:The mean epithelial healing time was (3.77±1.02) days.There were statistically significant differences in UCVA and BCVA between before and after surgery ( Z=380.812, 267.313; both at P<0.001). And the 7-day, 6-month, and 12-month postoperative BCVA were better than preoperative BCVA, showing statistically significant differences (all at P<0.05). Mean SI was 1.10±0.12, and mean EI was 1.05±0.17 at 12 months after surgery.There was no significant difference between the attempted SE before surgery (-8.02±1.36)D and the achieved SE at 12 months after surgery (-8.04±1.51)D ( P=0.523). SE in the predictive range within ±0.50 D accounted for 79% (85/107) and that within ±1.0 D accounted for 92% (98/107). The IOP was slightly increased in 3 eyes at 7 days and 7 eyes at 1 month after surgery, respectively, which returned to normal after the use of ophthalmic solution for lowing IOP.The incidence of haze severer than grade 1 was less than 1% (1 eye), and haze gradually disappeared after application of drugs. Conclusions:TransPRK assisted by SPT for high myopia shows good safety, effectiveness and predictability.It is an ideal corneal surface surgery to correct high myopia.
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Objective To evaluate the 1-year clinical outcome of orthokeratology contact lens wear and glasses wear for myopia in children,mainly focusing on the effects on the biological parameters of the eyeballs.Methods A randomized-controlled clinical study analyzed 200 eyes of 200 adolescent,with low and moderate myopia from January 2018 to August 2018 at Chengdu Aier Eye Hospital.The subjects were divided into an orthokeratology group and a spectacles group,100 eyes in each group.The axial lengths (AL),central corneal thickness (CCT),anterior chamber depth (ACD),and crystalline lens thickness were measured and compared between the two groups before and 6 months,12 months after wearing the lenses,and 1 month after stopping lens wear.This study conformed to the tenets of the Declaration of Helsinki.Written informed consent was obtained from each subject prior to entering the study cohort.The study protocol was approved by the Ethics Committee of Chengdu Aier Eye Hospital (No.[2018]01-1).Results The overall difference in AL was statistically significant in the two groups at various time points (Fgroup =4.617,P =0.043;Ftime =10.939,P =0.023).Compared with before wearing lenses,the AL was significantly lengthened in both of the groups at 6 and 12 months after wearing lenses and 1 month after stopping lens wear (all at P＜ 0.05).There was no significant difference in AL between 1 month after stopping lens wear and 12 months after wearing lenses in the orthokeratology group (P＞0.05).Twelve months after wearing lenses,the AL increases values of the orthokeratology group were significantly lower than those of the spectacles group ([0.13±0.06]mm vs.[0.29±0.08] mm) (t=16.000,P=0.002).The differences in CCT at time points in the two groups were statistically significant (Fgroup =2.297,P =0.013;Ftime =11.219,P＜ 0.01).At 6 and 12 months after wearing the lenses,the CCT in the orthokeratology group was significantly thinner than that before lens wear (all at P＜ 0.05).CCT showed no significant difference between 1 month after stopping lens wear and before wearing lenses in the orthokeratology group (P＞0.05).There was no statistically significanant difference in the ACD between the two groups at time points (Fgroup =4.226,P =0.051;Ftime =3.208,P=0.057).The overall differences in crystalline lens thickness at time points before and after wearing lenses in the two groups were statistically significant (Fgroup =13.13,P＜0.01;Ftime =0.804,P =0.047).At 6 and 12 months after wearing the lenses and 1 month after stopping lens wear,the crystalline lens thickness in the orthokeratology group was significantly greater than that before lens wear and that in the spectacles group at the same time points (all at P＜0.05).There was no significant difference in the crystalline lens thickness between 1 month after stopping lens wear and 12 months after wearing the lenses in the orthokeratology group (P＞0.05).Conclusions Compared with wearing spectacles,orthokeratology lenses wear can effectively slow down the prolongation of the AL,decrease CCT reversibly and increase crystalline lens thickness in adolescent myopic subjects,but it has no significant effect on the ACD.
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Objective@#To evaluate the 1-year clinical outcome of orthokeratology contact lens wear and glasses wear for myopia in children, mainly focusing on the effects on the biological parameters of the eyeballs.@*Methods@#A randomized-controlled clinical study analyzed 200 eyes of 200 adolescent, with low and moderate myopia from January 2018 to August 2018 at Chengdu Aier Eye Hospital.The subjects were divided into an orthokeratology group and a spectacles group, 100 eyes in each group.The axial lengths (AL), central corneal thickness (CCT), anterior chamber depth (ACD), and crystalline lens thickness were measured and compared between the two groups before and 6 months, 12 months after wearing the lenses, and 1 month after stopping lens wear.This study conformed to the tenets of the Declaration of Helsinki.Written informed consent was obtained from each subject prior to entering the study cohort.The study protocol was approved by the Ethics Committee of Chengdu Aier Eye Hospital (No.[2018]01-1).@*Results@#The overall difference in AL was statistically significant in the two groups at various time points(Fgroup= 4.617, P=0.043; Ftime=10.939, P=0.023). Compared with before wearing lenses, the AL was significantly lengthened in both of the groups at 6 and 12 months after wearing lenses and 1 month after stopping lens wear (all at P<0.05). There was no significant difference in AL between 1 month after stopping lens wear and 12 months after wearing lenses in the orthokeratology group (P>0.05). Twelve months after wearing lenses, the AL increases values of the orthokeratology group were significantly lower than those of the spectacles group ([0.13±0.06]mm vs. [0.29±0.08]mm) (t=16.000, P=0.002). The differences in CCT at time points in the two groups were statistically significant (Fgroup=2.297, P=0.013; Ftime=11.219, P<0.01). At 6 and 12 months after wearing the lenses, the CCT in the orthokeratology group was significantly thinner than that before lens wear (all at P<0.05). CCT showed no significant difference between 1 month after stopping lens wear and before wearing lenses in the orthokeratology group (P>0.05). There was no statistically significanant difference in the ACD between the two groups at time points (Fgroup=4.226, P=0.051; Ftime=3.208, P=0.057). The overall differences in crystalline lens thickness at time points before and after wearing lenses in the two groups were statistically significant (Fgroup=13.13, P<0.01; Ftime=0.804, P=0.047). At 6 and 12 months after wearing the lenses and 1 month after stopping lens wear, the crystalline lens thickness in the orthokeratology group was significantly greater than that before lens wear and that in the spectacles group at the same time points (all at P<0.05). There was no significant difference in the crystalline lens thickness between 1 month after stopping lens wear and 12 months after wearing the lenses in the orthokeratology group (P>0.05).@*Conclusions@#Compared with wearing spectacles, orthokeratology lenses wear can effectively slow down the prolongation of the AL, decrease CCT reversibly and increase crystalline lens thickness in adolescent myopic subjects, but it has no significant effect on the ACD.
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Background Carbachol solution (0.01％) is an agonist of M cholinoceptor and skeletal muscle N cholinoceptor,and it is used to play miotic effect and open peripheral iridectomic hole during the surgery of implantable collamer lens (ICL) implantation in order to lower intraocular pressure (IOP).However,the anterior chamber injection of 0.01％ carbachol solution often causes relevant complications,while whether lower dose of carbachol solution is effective and safe is unclear.Objective This study was to compare the effectiveness and safety between 0.01％ carbachol solution and 0.005％ carbachol solution after anterior chamber injection during the ICL implantation.Methods One hundred and fifty-two eyes of 76 cataract patients were included in Daping Hospital of Third Military Medical University from September 2014 to September 2015.ICL implantation and periphery iridectomy were carried out on both eyes of the patients and the 0.01％ carbachol solution was injected into the anterior chamber during the surgery of the right eyes and 0.01％ carbachol solution was used in the left eyes.The operation duration and IOP at postoperative 2 hours and systemic choline-like reaction were compared between 0.01％ carbachol solution group and 0.005％ carbachol solution group.Results The mean operation duration was (11.86± 2.39) minutes and (11.22 ± 1.85) minutes in the 0.01％ carbachol group and 0.005％ carbachol group,without significant difference between two groups (t =1.851,P =0.066).IOP was (15.76 ± 2.18) mmHg and (13.58 ±2.24)mmHg in the 0.01％ carbachol group before and after surgery,and those in the 0.005％ carbachol group was (15.70±2.35)mmHg and (13.12±2.17)mmHg,there was no significant difference in the IOP between the two concentrations of carbachol (Fsroup =0.986,P=O.322).The IOP at postoperative 2 hours was lower than that before operation,the difference was statistically significant(Ftime =97.339,P =0.000).There was no interaction between drug concentration and time (Fcorrelation =0.772,P =0.381).The incidences of complications,such as dizziness,nausea and vomiting,were lower in the 0.005％ carbachol group than those in the 0.01％ carbachol group (x2 =13.01,5.16,4.03,all at P＜0.05).Conclusions Carbachol solution (0.005％) can play intraoperative miosis effect and maintain effective operation duration in ICL implantation.In addition,the application of 0.005％ carbachol solution is quite safe in both intraoperation and postoperation.
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Background It has not been reported that if the visual cortex M receptor changed during the development of myopia and how it changed if given acupuncture treatment.Objective The aim of this study was to observe the effect of electroacupuncture stimulation on the expression of acetylcholine receptors M1 (AchRM1) in visual cortex of guinea with lens-induced myopia (LIM).Methods Forty-eight three-week-old healthy guinea pigs were randomized into the normal control group,the LIM model group and the LIM electroacupuncture group.The right eyes of the guinea pigs were selected as the experimental eyes.LIM was created by monocularly wearing of-10 D lens for 4 weeks in the right eyes in the LIM model group and LIM electroacupuncture group,and then the acupuncture at the temple and hegu point was performed for 30 minutes per day for consequent 4 weeks,in the LIM electroacupuncture group.The fellow eyes of the guinea pigs were used as the self-control eyes.The refractive power and axial length were examined with retinoscopy and A-type sonography before and 4 weeks after modeling,respectively.The animals were sacrificed by excessive anesthesia at the fourth week after acupuncture and visual vertex tissue was obtained.The expression of M1 receptor mRNA in visual vertex was detected by fluorescence quantitative PCR,and the content of M1 receptor protein in visual vertex was assyed by ELISA.The study protocal was approved by Animal Ethic Committee of Shandong University of Traditional Chinese Medicine,and the use and care complied with Statement of the Association for Research in Vision and Ophthalmology.Results At the fourth week after modeling,the mean diopters were (-3.24±0.28) D and (-3.30±0.45) D in the LIM model group and the LIM eleetroacupuncture group,which were significantly higher than (0.83 ±0.86)D in the normal control group (both at P=0.000),and there was no significant difference in the diopter between the LIM model group and the LIM electroacupuncture group (t =0.200,P =0.659).The mean axial lengths were (8.67 ±0.14) mm and (8.60±0.06) mm in the LIM model group and the LIM electroacupuncture group,which were considerably increased in comparison with (8.33±0.08)mm in the normal control group (both at P＜0.05).The relative expression levels of AchRM1 mRNA in visual cortex were 0.79±0.18,1.36±0.23 and 1.13±0.13 in the normal control group,LIM model group and LIM electroacupuncture group,and the relative expression level of AchRM1 mRNA in the LIM electroacupuncture group was significantly higher than that of the normal control group and lower than that of the LIM model group (both at P＜0.05).In addition,the contents of AchRM1 receptor protein in the visual cortex were 248.00±33.31,455.17±42.40 and 396.17±47.57 in the normal control group,LIM model group and the LIM electroacupuncture group,with a similar pattern among the groups (both at P＜0.05).Conclusions A electroacupuncture stimmulation do not affect the myopic diopter and axial length in LIM model.The AchRM1 and AchRM1 receptor in the visual cortex up-regulate in LIM eyes,infering that electroacupuncture stimmulation can improve vision by decreasing the level of AchRM1 receptor in visual cortex in LIM eyes in guinea pigs.
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Objective To analyze the factors related to glare occurred after the phakic intraocular lens (P-IOL) implantation,and to raise the standard for the P-IOL selection.Design Retrospective case series.Participants 104 patients with high myopia underwent P-IOL implantation in Beijing Tongren Hospital.Methods In 104 cases,22 cases (22 eyes) were implanted angle supported Phakic6 designed accord with corneal symmetry,54 cases (54 eyes) were implanted iris fixed Verisyse,and 28 cases (28 eyes) were implanted posterior chamber PRL.Selection of the diameter of P-IOL optics depended on P-IOL diopters.The pupil diameter,the P-IOL optic center position,the pupil and corneal center position were measured with anterior segment optical coherence tomography (OCT).The contrast sensitivity (CS) under different condition (day,day and glare,night,night and glare) and in different space frequency (1.5,3,6, 12,18c/d)were examined with Optec6500 system.Main Outcome Measures Glare incidence,CS,and the influence of pupil diameter and P-IOL location to glare.Results None of the 104 P-IOL eyes occurred glare in day time.59 eyes (56.73%) complained of glare in dime condition.The glare incidence was 63.18% (14/22) in Phakic6 eyes,55.56% (30/54) in Verisyse eyes,and 53.27% (15/28) in PRL eyes (P=0.691).CS of all surgical eyes were improved in day time with or without glare luminous environment (P=0.000).And the CS of halo-complaining eyes was lower than of no halo eyes in night time with or without glare luminous environment (P=0.000).Glare oc- curred more frequently in eyes with the pupil diameter larger than P-IOL diameter in clime condition after surgery (10 in Phakic6 eyes, 20 in Verisyse eyes,12 in PRL eyes,all P