A novel injectable thermo/photo dual-crosslinking hydrogel based on modified chitosan for fast sealing open globe injury.

Open globe injuries (OGIs) demand immediate attention to prevent further complications and improve vision prognosis. Herein, we developed a thermo/photo dual-crosslinking injectable hydrogel, HBC_m_Arg, for rapidly sealing OGIs in emergency ophthalmic cases. HBC_m_Arg was prepared with arginine and methacrylic anhydride modified hydroxybutyl chitosan (HBC). HBC_m_Arg was initially in liquid form at 25 °C, enabling easy injection at the injury site. After reaching the ocular surface temperature, it underwent reversible heat-induced gelation to achieve in situ transformation. Further, HBC_m_Arg was capable of rapid photocrosslinking under UV light, forming a dual network structure to bolster mechanical strength, thereby facilitating effective OGI closure. Biocompatibility assessments, including in vitro studies with three ocular cell types and in vivo experiments on rabbit eyes, confirmed the safety profile of HBC_m_Arg. Ex vivo and in vivo burst pressure tests demonstrated the hydrogel's ability to promptly restore intraocular pressure and withstand elevated pressures, underscoring its potential for OGI stabilization. Additionally, the suitable degradation of HBC_m_Arg within ocular tissues, coupled with its stability in ex vivo assessments, presented a delicate balance between stability and biodegradability. In conclusion, HBC_m_Arg holds promise for improving emergency ophthalmic care by providing a rapid, effective, and safe way to seal OGIs in critical situations.

Artificial Intelligence in Ophthalmic Surgery: Current Applications and Expectations.

Artificial Intelligence (AI) has found rapidly growing applications in ophthalmology, achieving robust recognition and classification in most kind of ocular diseases. Ophthalmic surgery is one of the most delicate microsurgery, requiring high fineness and stability of surgeons. The massive demand of the AI assist ophthalmic surgery will constitute an important factor in boosting accelerate precision medicine. In clinical practice, it is instrumental to update and review the considerable evidence of the current AI technologies utilized in the investigation of ophthalmic surgery involved in both the progression and innovation of precision medicine. Bibliographic databases including PubMed and Google Scholar were searched using keywords such as "ophthalmic surgery", "surgical selection", "candidate screening", and "robot-assisted surgery" to find articles about AI technology published from 2018 to 2023. In addition to the Editorials and letters to the editor, all types of approaches are considered. In this paper, we will provide an up-to-date review of artificial intelligence in eye surgery, with a specific focus on its application to candidate screening, surgery selection, postoperative prediction, and real-time intraoperative guidance.