Biometric factors associated with the postoperative visual performance of a multifocal intraocular lens.

Purpose: To identify the biometric factors associated with postoperative visual performance after uneventful phacoemulsification with multifocal intraocular lens (MIOL) implantation. Methods: In this retrospective cohort study, 72 eyes of 72 patients implanted with the HumanOptics Diff-aAY MIOL were included. Preoperative examination data including the white-to-white distance (WTW), anterior chamber depth (ACD), axial length and corneal astigmatism were gathered through the electronic medical records. One month postoperatively, the pupil parameters, corneal aberrations, corneal astigmatism, IOL tilts and IOL decentrations were measured using an OPD-Scan III aberrometer. Postoperative visual performance parameters were recorded as the visual acuity, depth of focus, modulation transfer function (MTF) and point spread function (PSF) values, area under log contrast sensitivity function (AULCSF), retinal straylight and visual function questionnaire scores. Univariate and multivariate linear regression analyses were then performed to evaluate the associations between the potential biometric factors and postoperative visual outcomes. Results: Younger age predicted greater MTF and PSF values, better AULCSF and better retinal straylight (P < 0.05). A lower corneal trefoil predicted better MTF and PSF values (P < 0.05). Smaller IOL decentration predicted better distance-corrected near visual acuity, greater AULCSF and better retinal straylight (P < 0.05). A less negative spherical equivalent (SE) predicted better MTF values (P = 0.017), while a more negative SE predicted better Visual Function Index-14 (VF-14) questionnaire scores and satisfaction scores (P < 0.05). A higher IOL power predicted better best corrected distance visual acuity (P = 0.005). Lower preoperative corneal astigmatism predicted greater MTF values (P = 0.020). Lower postoperative corneal astigmatism, smaller corneal high-order aberrations (HOAs), smaller photopic pupil size, larger WTW and deeper ACD predicted a better AULCSF (P < 0.05). Conclusions: IOL decentration, IOL power, age, preoperative and postoperative corneal astigmatism, SE, photopic pupil size, corneal trefoil, WTW, ACD and corneal HOAs were significantly associated with postoperative visual performance. These findings might aid in patient selection prior to MIOL implantation.

Comparison of B-Scan ultrasonography, ultra-widefield fundus imaging, and indirect ophthalmoscopy in detecting retinal breaks in cataractous eyes.

BACKGROUND/OBJECTIVES: To evaluate the diagnostic performance of B-scan kinetic ultrasonography (USG), standard ultra-widefield (UWF) imaging, and indirect ophthalmoscopy (IDO) in retinal break detection in cataractous eyes. SUBJECTS/METHODS: We consecutively enrolled 126 cataract patients (including 246 eyes) with no comorbidities that could decrease best corrected visual acuity (BCVA). Three index tests (USG, nonmydriatic UWF, and mydriatic IDO) were performed preoperatively to screen for retinal breaks. One week after cataract extraction, a dilated IDO examination was repeated for the definitive diagnosis of retinal break as the reference standard. The sensitivity, specificity, Youden index (YI), and predictive values of each index test were calculated according to postoperative ophthalmoscopic findings. A deep-learning nomogram was developed to quantify the risk of retinal break presence using patients' baseline data and findings reported from preoperative ophthalmic tests. RESULTS: Fifty-two eyes (21%) were excluded from appropriate preoperative UWF imaging because of massive lens opacity. The BCVA cutoff point with maximum YI indicating UWF applicability was 0.6 logMAR (YI = 0.3; area under curve [AUC] = 0.7). Among all 246 eyes, preoperative IDO, USG, and UWF showed fair interobserver agreement (all κ > 0.2). According to postoperative IDO findings, the index tests with the highest sensitivity and specificity were USG (100%) and preoperative IDO (99%), respectively. CONCLUSIONS: For cataractous eyes without vision-impairing comorbidities, a BCVA better than 0.6 logMAR (Snellen acuity, 20/80) allows for appropriate nonmydriatic standard UWF imaging. In a high-volume clinic equipped with skilled ophthalmic examiners, screening with USG followed by directed IDO allows the efficient identification of retinal breaks in cataractous eyes.

Association Between Endothelial Cell Density and Corneal Thickness in Medium, Short, and Long Eyes of Han Chinese Cataract Patients.

PURPOSE: To evaluate the association between the endothelial cell density (ECD) and central corneal thickness (CCT) in medium, short, and long eyes of preoperative Han Chinese cataract patients. DESIGN: Retrospective cross-sectional study. METHODS: We consecutively enrolled 410 eyes, namely, 50 short eyes (axial length [AL]<22.0 mm), 150 medium eyes (22.0≤AL<24.0 mm), 120 medium-long eyes (24.0≤AL<26.0 mm), and 90 long eyes (AL≥26.0 mm), of 410 adult patients scheduled for cataract surgery. The ECD and CCT were determined preoperatively with a noncontact specular microscope. The association between the CCT and ECD was identified by using a multivariable regression analysis. A thin cornea was defined as having a CCT less than 500 µm. RESULTS: After adjusting for age, the presence of arterial hypertension, the presence of diabetes mellitus, intraocular pressure, and AL, a positive association between the CCT and ECD was identified in short eyes (linear regression coefficient [B]=3.40; standardized B [ß]=0.52; P = .03), medium eyes (B = 2.33; ß=0.28; P = .002), medium-long eyes (B = 1.84; ß=0.25; P = .02), and long eyes (B = 2.69; ß=0.41; P = .04). In the total group, the multivariable logistic analysis showed a significant link between the presence of a thin cornea and a lower ECD (odds ratio [OR]=0.80 per 100 cells/mm2 increase; P = .001). CONCLUSIONS: For cataract patients of Han ethnicity, a significant association between a thin CCT and a lower ECD was shown across the AL spectrum and was most prominent in short eyes. Eyes with a thin cornea are more likely to have a lower ECD.

Influence of Ocular Biometry Parameters on the Predictive Accuracy of IOL Power Formulas in Patients with High Myopia.

INTRODUCTION: The aim of this study was to investigate the influence of ocular biometry parameters on the predictive accuracy of 10 intraocular lens (IOL) power formulas in patients with high myopia (HM). METHODS: We analyzed 202 eyes of 202 patients. The ocular biometry was determined preoperatively using an IOLMaster 700. The associations between the biometry parameters and the prediction error (PE) 1 month postoperatively were assessed. HM was defined as an axial length exceeding 26.50 mm. RESULTS: In patients with HM (n = 108), the K6, Emmetropia Verifying Optical (EVO), Olsen, and Barrett Universal II (BUII) formulas had the lowest absolute PEs among the 10 formulas. The ocular biometry parameters were not associated with the PE of K6, EVO, Olsen, or BUII. A longer axial length in HM eyes was associated with myopic outcomes by Kane, Hoffer QST, and VRF and hyperopic outcomes by Holladay 2 and T2. Steeper keratometry, a deeper anterior chamber, and a thicker lens were associated with a hyperopic shift in HM eyes when using VRF, Kane, and Hoffer QST, respectively. In patients without HM (n = 94), there was no difference between the formulas in absolute PE. The significant associations between the biometry parameters and PE in patients with HM were not present in patients without HM. CONCLUSIONS: K6, EVO, Olsen, and BUII displayed high accuracy in HM eyes and were not influenced by preoperative biometry parameters. For the remaining formulas, the preoperative keratometry, anterior chamber depth, lens thickness, and axial length were possible error sources underlying an inaccurate IOL power prediction in patients with HM.

Interfacial Self-Assembly of Organized Ultrathin Films of Tripodal Metal-Terpyridyl Coordination Polymers as Luminophores and Heterogeneous Catalysts for Photocatalytic CO2 Reduction.

Metal-directed interfacial self-assembly of well-defined coordination polymer (CP) ultrathin films can control the metal complex arrangement and distribution at the molecular level, providing a convenient route for the design and fabrication of novel opto-electrical devices and heterogeneous catalysts. Here, we report the assembly of two series of CP multilayers with the transition-metal ions of Fe2+, Co2+, Zn2+ and Tb3+ as connectors and tripodal terpyridyl ligands of 4,4',4″-(1,3,5-triazine-2,4,6-triyl)tris(1-(4-([2,2':6',2″-terpyridin]-4'-yl)benzyl)pyridin-1-ium) (TerPyTa) and 4,4',4″-(benzene-1,3,5-triyl)tris(1-(4-([2,2':6',2″-terpyridin]-4'-yl)benzyl)pyridin-1-ium) (TerPyBen) as linkers at the air-water interface. The as-prepared Langmuir-Blodgett (LB) films display strong luminescence, with the emission wavelength and relative intensity dependent on both the metal ions and linkers; among them, the Zn-TerPyTa and Zn-TerPyBen CPs give off the strongest luminescent emission centered at about 370 nm with an emission lifetime of approximately 0.2-0.3 ns. The Tb-TerPyTa CPs can give off emission at approximately 490, 546, 586, and 622 nm, attributed to the 5D4 to 7F3-6 electron transitions of typical Tb3+ ions. Finally, these CP LB films can act as efficient heterogeneous photocatalysts for the CO2 reduction to selectively produce CO. The catalytic efficiency can be optimized by adjusting the experimental conditions (light sensitizer, electron donor, and water content) and CP composition (metal ion and ligand) with an excellent yield of up to 248.1 mmol g-1. In particular, it is revealed that, under the same conditions, the catalytic efficiency of the Fe-TerPyTa CP LB film is nearly 2 to 3 orders of magnitude higher than that of the other metalated complexes investigated in the homogeneous system. UV-vis spectroscopy and cyclic voltammetry studies demonstrated that the dual active sites of Fe-terpyridine and TerPyTa units contribute to the enhanced catalytic activity. This work provides an effective method to introduce the earth-abundant metal complexes into CP films to construct efficient noble-metal-free photocatalysts for the CO2 reduction.

Supracapsular scleral sutured intraocular lens implantation in anterior segment dysgenesis patients with ectopia lentis.

OBJECTIVE: To describe a new strategy to manage ectopia lentis in ASD patients assessing the visual outcomes and safety of supracapsular scleral sutured intraocular lens implantation and analyzing the accuracy of different intraocular lens (IOL) power calculation formulae. METHODS: Eight patients with ASD (13 eyes) were underwent supracapsular scleral suture fixation of posterior chamber (PC) IOL without capsular extirpation. The preoperative and postoperative clinical features were compared. The prediction error values from four formulae (SRK/T, Holladay 1, Hoffer Q, Haigis), with or without Wang-Koch (WK) adjustment, were calculated for the cases. RESULTS: Zonulodialysis and premature cataracts could be the main reason for the decreased vision in patients with ASD. There was a significant improvement in best corrected visual acuity on 3-month follow-up after applying supracapsular scleral suture fixation of PC IOL. The prediction errors of the different formulae showed a slight tendency towards postoperative myopia. The Haigis formula with WK adjustment showed the best performance. CONCLUSIONS: Supracapsular scleral suture fixation of IOLs for retaining the capsule-zonule barrier is a good option for ASD patients. The Haigis formula is recommended for ASD patients treated with supracapsular scleral suture fixation of IOLs. The predicted IOL power should be reduced based on the effect of the new anatomic position of the IOL to achieve a satisfactory visual outcome.

Influence of miosis and laser peripheral iridotomy on intraocular lens power calculation in patients with primary angle closure disease.

OBJECTIVES: To evaluate the effect of miosis and laser peripheral iridotomy (LPI) on intraocular lens (IOL) power prediction and ocular biometry in eyes with primary angle closure disease (PACD). METHODS: In this prospective observational study, primary angle closure suspects (PACS), and subjects classified with primary angle closure (PAC)/primary angle-closure glaucoma (PACG) undergoing LPI were enrolled. Ocular biometric parameters were measured with IOLMaster700 at baseline (T0), one week after pilocarpine instillation (T1), and another week post LPI (T2). Biometric changes and the IOL power predicted for emmetropia using Barrett Universal II, Haigis, Holladay2, Hoffer Q and SRK/T formulae were analysed and compared among different time points. RESULTS: 100 eyes of 50 PACS and 50 PAC/PACG patients were enrolled. Following pilocarpine-induced miosis, lens thickness (LT) increased and anterior chamber depth (ACD) decreased (all groups p < 0.01), while white-to-white diameter decreased and central corneal thickness increased significantly only in the PACS cohort (both p < 0.01). Compared to baseline, LPI induced an increase of ACD and a slight decrease of LT in PACS (both p < 0.01), whereas only axial length changed significantly (p = 0.012) in the PAC/PACG cohort. Regardless of the formula used, no significant difference to the predicted IOL power for emmetropia existed among the three time points in each group (all p > 0.1). CONCLUSION: We report the changes of anterior segment parameters induced by miosis and LPI in PACD. These interventions do not significantly affect the IOL power calculation predicted for emmetropia in Chinese eyes when common third-, fourth-and new generation IOL formulae are used.

A Comparative Study on the Accuracy of IOL Calculation Formulas in Nanophthalmos and Relative Anterior Microphthalmos.

PURPOSE: We sought to compare the prediction accuracy of 6 intraocular lens (IOL) formulas, namely, the Haigis, Hoffer Q, Holladay I, SRK/T, Barrett Universal II and Hoffer QST formulas, in microphthalmic eyes, including those with nanophthalmos and relative anterior microphthalmos (RAM). DESIGN: Retrospective case series. METHODS: Twenty-six eyes with nanophthalmos (axial length [AL] 16.84 ± 1.36 mm, range 15.25 mm-19.82 mm) and 12 eyes with RAM (corneal diameter 8.41 ± 0.92 mm, range 7.00 mm-9.50 mm) receiving cataract surgery were included. The IOL Master 500 was used for biometry; thus, lens thickness (LT) was omitted in the IOL power calculation. The mean and median arithmetic and absolute prediction errors (PEs) of the 6 original calculation formulas, the absolute PEs of the 6 formulas after optimization, and the proportion of PEs within ±0.25 diopters (D), ±0.5 D, ±1 D, and ±2 D with each formula were compared. The factors influencing PE were analyzed by multivariate regression. RESULTS: In the nanophthalmos group, the overall prediction results were shifted to myopia. The original Haigis formula had the smallest median absolute PE (1.61 D, P < 0.001), and the optimized Haigis formula had the highest proportion of PEs within ±0.25 D, ±0.5 D, and ±1 D. In the RAM group, the overall prediction results were not significantly different from 0 (P > .05). No significant difference was found among the formulas before optimization (P = .146) and after optimization (P = .161), but the optimized Barrett Universal II formula had the highest proportion of PEs within ±1 D and ±2 D. CONCLUSIONS: When omitting the LT parameter in the calculation, the Haigis formula was the most accurate in cataract patients with nanophthalmos (AL <20 mm) among the 6 IOL calculation formulas, and the Barrett Universal II formula had the highest accuracy in cataract patients with RAM (corneal diameter ≤9.5 mm).

Associations between anterior segment biometry and high axial myopia in 3438 cataractous eyes in the Chinese population.

BACKGROUND: To investigate the associations between anterior segment biometry and high axial myopia in cataractous eyes in the Chinese population. METHODS: Data on 3438 eyes from 3438 subjects were analyzed in this cross-sectional study. Anterior segment biometry, axial length measurements, and intraocular pressure evaluation were implemented using an Oculus Pentacam HR, a Zeiss IOLMaster 500, and a Nidek TonoRef II, respectively. A multivariate-adjusted logistic model and a multivariate-adjusted linear model were used for statistical analysis. RESULTS: The mean age of the subjects was 62.2 ± 10.6 years, and 56.4% were female. There were 2665 subjects with high axial myopia (axial length, ≥26.50 mm) and 773 without (axial length, < 26.50 mm). The characteristics independently associated with high axial myopia included lower total corneal refractive power, a more negative Q value, greater total corneal astigmatism, greater white-to-white corneal diameter, greater anterior chamber depth, and higher intraocular pressure (all P <  0.05). In addition, greater axial length correlated with a thicker temporal cornea and a thinner nasal cornea (both P <  0.001). CONCLUSIONS: For cataractous eyes, high axial myopia was associated with corneal flattening, increased total corneal astigmatism, anterior segment enlargement, and intraocular pressure elevation. The findings may inform the choice of intraocular lenses and the calculation of their power, help improve the surgical practice of refractive cataract procedures, and provide useful information on the centration and stability of intraocular lenses.

Distribution of Ocular Anterior and Posterior Segment Lengths Among a Cataract Surgical Population in Shanghai.

Purpose: To investigate the distributions of the ocular anterior and posterior segment lengths among a cataract surgical population in Shanghai. Design: Cross-sectional study. Methods: Ocular biometric parameters of 23,462 eyes of 23,462 cataract surgery candidates were reviewed. Axial length (AL), anterior chamber depth (ACD), and lens thickness (LT) were obtained using IOL Master. Anterior segment length (ASL = ACD + LT), posterior segment length (PSL = AL - ASL) and the ratio of ASL to PSL (ASL/PSL) were calculated. Results: The mean ASL was 7.58 ± 0.39 mm, the mean PSL was 17.12 ± 2.64 mm. As the age grew, the ASL increased, and PSL increased firstly then decreased. Male subjects tended to have significantly longer ASL and shorter PSL than female subjects. With the increasing AL, the ASL was firstly decreased to trough at 20-22 mm AL group, then increased gradually, while the PSL increased rapidly. The ASL correlated positively with AL in normal, moderate and highly myopic eyes, negatively in short eyes. The PSL correlated positively with AL across the entire study population. The ASL/PSL was not constant in the eyes with different AL but had a relatively steep downward trend with the increasing AL in the short eyes, then decreased smoothly in normal, moderate and highly myopic eyes. Conclusions: In Chinese cataractous eyes, longer ASL and shorter PSL were associated with elder age and male gender. The change of ASL over AL was not linear, and the ASL was smallest in the eyes with AL of 20-22 mm. The elongation of the eyeball was mainly due to the extension of the posterior segment.

Ratiometric fluorescence detection of anthrax biomarker based on terbium (III) functionalized graphitic carbon nitride nanosheets.

Detection of anthrax biomarker dipicolinic acid (DPA) is of great importance upon the crisis of bioterrorism. Development of fluorescent materials for DPA detection, particularly one that fully depends on single luminescent response, faces the challenge of being susceptible to interferences. The accompanying accuracy problems offer great opportunities for the establishment of more reliable ratiometric analysis method. Herein, a ratiometric fluorescent probe based on terbium functionalized graphitic carbon nitride nanosheets (Tb-g-C3N4NS) is attempted for quantitative detection of DPA to address the distinct function of g-C3N4NS as both carrier and reference fluorophore, which is a so-far unexplored option in fluorescent detection approaches. We achieve the incorporation of Tb3+ into framework of g-C3N4NS by using a simple synthetic strategy comprised of thermal pyrolysis and ultrasonic exfoliation. Combining the reference signal over g-C3N4NS at 440 nm (I440) with the response signal of Tb3+ at 546 nm (I546), concentration of DPA can be easily calculated via its linear correlation with the intensity ratio (I546/I440), giving a precise measurement towards DPA with a detection limit as low as 9.9 nM. Besides enabling an excellent self-calibrating detection of DPA, this work also inspires broader use of g-C3N4NS for relevant process.

Large-Area Assembly of Metal-Organic Layered Ultrathin Films at the Liquid/Liquid Interface.

Two-dimensional functional metal-organic frameworks and coordination polymers have attracted much attention and have been successfully prepared in solutions and at interfaces through the coordination of ligands to metal ions. However, the preparation of large-area ultrathin ordered films is still a challenge. Here, a modified liquid/liquid interfacial epitaxial growth method has been developed. A planar liquid/liquid interface between a chloroform solution of bipyridine derivatives and pure water was constructed first, and then an aqueous solution of Eu3+ or Cu2+ ions was added dropwise into the water phase. A layered ultrathin film with the size of several hundreds of square micrometers appeared at the liquid/liquid interface after a certain time. The monitoring results showed that the formation of ultrathin films was a result of continuous epitaxial growth of the adsorbed species due to the synergistic effects of hydrophobic effects of the alkyl chains, coordination bonds between the ligands and metal ions, π-π interactions between the ligands, and the restriction of the interface on the vertical growth. This offers a way to fabricate more large-area thin films of amphiphilic molecules.

Analysis of corneal astigmatism and aberration in chinese congenital cataract and developmental cataract patients before cataract surgery.

BACKGROUND: To investigate the distribution of corneal astigmatism, aberration, and biometric parameters in Chinese congenital cataract (CC) /developmental cataract patients before cataract surgery. METHODS: We evaluated eyes of CC /developmental cataract patients scheduled for cataract surgery from January 2016 to September 2019. Astigmatism, aberrations, and biometric parameters were measured with the Pentacam Scheimpflug imaging device (Pentacam HR, Oculus). Cataract was diagnosed and classified by slit-lamp examination after full mydriasis. RESULTS: We evaluated 538 eyes in 356 patients. The mean values of anterior corneal astigmatism (ACA), posterior corneal astigmatism (PCA), and total corneal astigmatism (TCA) were determined as 1.98 ± 1.06 D (range 0.0‒4.8 D), 0.49 ± 0.26 D (range 0.0‒1.9 D), and 2.09 ± 1.19 D (range 0.2‒8.8 D), respectively. ACA and TCA ≥ 1.25 D was present in 379 eyes (70.3%) and 392 eyes (72.8%), respectively. PCA between 0.25 D and 0.75 D was found in 380 eyes (70.6%). There was a statistically significant positive linear correlation between lower-order aberrations root mean square values (LOA RMS) and corneal astigmatism (CA). Furthermore, in terms of distribution of central cornea thickness, anterior chamber depth, ACA, PCA, and TCA in different types of cataracts, ACA was highest in patients with zonular cataracts. Finally, we found anterior corneal measurements may overestimate WTR astigmatism, underestimate ATR astigmatism, and underestimate oblique astigmatism, respectively. CONCLUSIONS: Most CC /developmental cataract patients had moderate to high astigmatism and ACA accounted for the largest proportion in the zonular group. This can provide a basis for planning of CC/developmental cataract surgery by ophthalmologists in clinical practice.

Evaluation of the White-to-White Distance in 39,986 Chinese Cataractous Eyes.

Purpose: To investigate the distribution of white-to-white (WTW) distance and its associations with other biometric parameters in Chinese cataractous eyes. Methods: Data on 39,986 eyes from 23,627 Chinese cataract patients were analyzed. Ocular biometric parameters, including WTW distance, corneal curvature, anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), and axial length (AL), were obtained using the ZEISS IOLMaster 700. Results: The mean age of patients was 63.7 ± 12.4 years, and 57.61% were female. The mean WTW distance was 11.69 ± 0.46 mm. The WTW distance was larger in male patients than in female patients for all age groups (all P < 0.001). The WTW distance was positively correlated with corneal curvature and ACD and negatively correlated with age, LT, and CCT (all P < 0.001). Multivariable analysis revealed that a larger WTW distance was associated with younger age; male gender; larger corneal curvature, ACD, and LT; and thinner CCT (all P < 0.001). Notably, the association between WTW distance and AL was not linear. As the AL increased, the WTW distance initially increased, reached a peak in the group with ALs of 24.5 to 26 mm, and then slowly decreased. However, all of the myopic eyes (AL > 24.5 mm) still had larger WTWs than the normal and short eyes (AL ≤ 24.5 mm). Conclusions: In Chinese cataractous eyes, the WTW distance was larger in younger male patients with flatter corneas, deeper anterior chambers, thicker lenses, and thinner central corneas. The association between WTW distance and AL was not linear, and WTW distance was the largest in eyes with ALs of 24.5 to 26 mm.

Three-Year Outcomes of Cionni-Modified Capsular Tension Ring Implantation in Children Under 8 Years Old With Ectopia Lentis.

PURPOSE: This study evaluated visual outcomes and complications at 3 years post-implantation of a Cionni-modified capsular tension ring (MCTR) with an intraocular lens (IOL) in ectopia lentis patients ≤8 years old. DESIGN: Prospective clinical cohort study. METHODS: Included were 101 eyes from 57 patients <8 years of age, who underwent surgery for nontraumatic ectopia lentis between November 2015 and December 2016. Exclusion criteria were planned IOL fixation in the ciliary sulcus, severe intraoperative complications, and incomplete follow-up. All eyes received in-the-bag implantation of a posterior IOL and Cionni-MCTR. Posterior capsulectomy and anterior vitrectomy were performed through the pars plana in 23 eyes of children <5 years of age. Patients were examined at 1 day, and 1, 6, and 12 months, and at 2 and 3 years postoperatively. Outcome; measurements included best-corrected visual acuity (BCVA), intraocular pressure (IOP), IOL centration, and posterior capsule opacification (PCO). RESULTS: In all eyes, BCVA improved significantly after surgery, especially during the first 12 months (P < .05). Three years post-operatively, 44 eyes had BCVA 0.9 or better. Prophylactic Nd:YAG laser capsulotomy was performed 3 months post-surgery in 24 eyes; 34 eyes underwent this; procedure 6 months post-surgery because of PCO. A second surgery was; warranted in 4 eyes because of severe IOL decentration and combined anterior capsule contraction. No severe postoperative complications, such as retinal detachment or endophthalmitis, occurred. CONCLUSIONS: Implantation of in-the-bag IOL with Cionni MCTR is effective for visual rehabilitation in young children with ectopia lentis. A close follow-up of these patients is necessary to monitor IOL centration and stability.

Distribution of angle α and angle κ in a population with cataract in Shanghai.

PURPOSE: To describe the distribution of angle α and angle κ in a population with cataract in Shanghai. SETTING: Eye and Ear, Nose, Throat Hospital, Fudan University, Shanghai, China. DESIGN: Hospital-based, cross-sectional study. METHODS: Angle α, angle κ, and other ocular biometric parameters were determined by IOLMaster 700. The distributions of angle α and angle κ and their associations with systemic and ocular parameters were assessed. RESULTS: This study included 15 127 eyes of 15 127 cataract patients. The mean angle α and angle κ values were 0.45 ± 0.21 mm and 0.30 ± 0.18 mm, respectively. Angle α and angle κ were both predominantly located temporal to the visual axis. A greater angle α or angle κ was associated with older age, lower corneal power, shorter white-to-white distance, and shallower anterior chamber depth (all P < .05). Angle α correlated positively with angle κ. With increasing axial length (AL), angle α gradually decreased in a nonlinear way and shifted to the nasal side of the visual axis, whereas angle κ decreased in eyes with AL less than 27.5 mm but increased again in eyes with longer AL. CONCLUSIONS: Angle α and angle κ, both predominantly located temporal to the visual axis, were influenced by multiple anterior segment parameters. As AL increased, the changes in angle α and angle κ were nonlinear, and their locations gradually shifted from the temporal to the nasal side of the visual axis.

Visual Luminescent Probes Constructed by Eu3+ Complex-Functionalized Silica Nanocomposites and Their Langmuir-Blodgett Films at Interfaces.

The trivalent europium ion (Eu3+) has garnered a great deal of interest for the design of luminescent materials possessing compound-independent emission bands, strong luminescent intensity, and long emission lifetimes. We herein introduce a synthetic methodology capable of constructing visual luminescent probes from Eu3+ complex-functionalized silica nanocomposites and their Langmuir-Blodgett (LB) films at interfaces. In order to facilitate the coordinative stabilization of Eu3+ over carrier surfaces, silica nanoparticles (nanoSiO2) were pregrafted with terpyridyl (TPy) to make nanoSiO2TPy linkers. Then, a well-designed coordination reaction of nanoSiO2TPy with EuCl3 and 2,6-pyridinedicarboxylic acid (DPA) was carried out at solid-liquid and air-water interfaces, where our desired material (denoted as nanoSiO2TPy@EuDPA) and its corresponding LB film are obtained. The presence of TPy and DPA interacting with Eu3+ plays a key role in regulating the chemical nature of the particle surface, hence giving rise to closely packed nanocomposite arrays in the film. As a result, the improvement in uniformity and stability is achieved alongside the enhancement in emission intensity and lifetime. With such advantageous optical properties, we find them workable as facile, green, and affordable luminescent sensors, by which a range of common toxic anions (Cr2O72-, MnO4-, and PO43-) can be visually and quantitatively recognized. Notably, the LB film-based material could afford a higher Ksv value (1.53 × 105 M-1), a lower detection limit (0.157 µM), and better recyclability than its original powder analogue, showcasing its utility as a more promising candidate for practical use.

Measurement of crystalline lens tilt in high myopic eyes before cataract surgery using swept-source optical coherence tomography.

BACKGROUND: To measure the crystalline lens tilt in eyes with various degrees of myopia before cataract surgery using swept-source optical coherence tomography (SS-OCT). METHODS: We used SS-OCT (IOLMaster 700) to scan 131 emmetropic eyes (axial length < 24.5 mm), 25 mild/moderate myopic eyes (axial length 24.5-26 mm), and 123 high myopic eyes (52, 29, and 42 eyes with axial lengths of 26-28, 28-30, and > 30 mm, respectively) as part of the routine preoperative examination before cataract surgery. SS-OCT involved B-scans along six meridians. The data were analyzed to assess the magnitude and orientation of the lens tilt and their correlation with other optical biometric parameters. RESULT: The mean tilt was 3.36 ± 0.98° in emmetropic eyes, 3.07 ± 1.04° in mild/medium myopic eyes, and 2.35 ± 1.01° in high myopic eyes. Tilt correlated significantly and inversely with axial length (Pearson's r = - 0.427, P < 0.001). The crystalline lens tilt predominantly faced the upper outer quadrant relative to the visual axis, symmetrically in both eyes, with mean angles of 24.32° and 147.36° in the right and left eyes, respectively. The variability in the lens tilt direction increased with increasing axial length (χ2 test, P < 0.001). CONCLUSION: The magnitude of crystalline lens tilt decreased with increasing axial length. The direction of tilt was predominantly towards the upper outer quadrant in both eyes. The variability in the tilt orientation increased with increasing axial length. TRIAL REGISTRATION: NIH (clinicaltrial.gov), NCT03062085. Registered 23 February 2017.

Influences of the three-dimensional parameters of pterygium on corneal astigmatism and the intraocular lens power calculation.

Pterygium morphology had great effect on corneal astigmatism and intraocular lens (IOL) power calculation in cataract patients. However, previous studies all focused on the pterygium surface parameters, the invasion degree or cross-sectional area of the pterygia into the corneal stroma were neglected. We studied the effect of three-dimensional parameters of pterygium on corneal astigmatism and IOL power prediction. We enrolled 81 eyes of 81 patients with primary nasal pterygium, measured the corneal astigmatism (Pentacam HR) and predicted IOL power change (IOLmaster500) before and after pterygium surgery. The three-dimensional parameters of pterygium (length, width, area, height and invasion cross-sectional area) were measured by slit lamp photography and Scheimpflug images. After pterygium surgery, corneal astigmatism decreased from 4.35 ± 4.24 to 1.07 ± 0.95 D and total corneal refractive power increased from 43.02 ± 1.96 to 43.95 ± 0.95 D (both P < 0.001). The predicted IOL power decreased from 22.87 ± 2.82 to 21.71 ± 2.85 D (P < 0.001) after surgery. Notably, 34 eyes (41.98%) had ≥3.0 D of pterygium induced astigmatism (PIA), and 33 eyes (40.74%) had ≥1.0 D of predicted IOL power change. PIA was independently influenced by the pterygium surface area (r = 0.43, P < 0.001) and cross-sectional area (r = 1.25, P = 0.018), while the predicted IOL power change was independently affected by the pterygium width (r = 0.70, P < 0.001). Cataract surgeons could evaluate the effects of a pterygium according to its three-dimensional parameters and prepare an optimal surgical strategy for cataract combined pterygium patients.