Comparison of low-energy femtosecond laser-assisted and conventional cataract surgery: a meta-analysis and systematic review.

TOPIC: To systematically compare the effectiveness of conventional phacoemulsification surgery (CPS) and low-energy femtosecond laser-assisted cataract surgery (FLACS) in patients with cataract. CLINICAL RELEVANCE: Cataract surgery is a common procedure, and comparing different techniques such as CPS and low-energy FLACS is crucial for optimizing patient outcomes. METHODS: The PubMed, Web of Science, MEDLINE, EMBASE, and Cochrane library databases were searched for clinical trials. Outcomes of procedure time, effective phacoemulsification time, balanced salt solution usage, cumulative dissipated energy, mean change of best-corrected visual acuity, endothelial cells reduction, central corneal thickness, and aqueous cytokine level were evaluated. The effect measures were weighted mean differences with 95% confidence interval. The protocol was registered at the Prospective Register for Systematic Reviews (PROSPERO, registration number CRD42023420173). RESULTS: 11 studies were included in the present meta-analysis, of which 1680 eyes were analyzed (637 eyes in the low-energy FLACS group, and 1043 eyes in the CPS group). Low-energy FLACS demonstrated significantly fewer reductions in endothelial cell count at six months (p<0.001) compared to CPS. It also exhibited a shorter effective phacoemulsification time (p<0.001) and less balanced salt solution usage (P<0.001). However, there were no differences in cumulative dissipated energy, corrected distance visual acuity, central corneal thickness changes, or aqueous cytokine levels between the two groups. CONCLUSION: Both low-energy FLACS and CPS are effective in treating cataracts, but low-energy FLACS may offer advantages such as reduced phacoemulsification time and less endothelial cell loss.

Retinal pigment epithelium tear in an idiopathic acute onset bullous central serous chorioretinopathy.

Although retinal pigment epithelium (RPE) tears are common in patients with chronic conditions such as exudative age-related macular degeneration or may occur in response to anti-vascular endothelial growth factor or laser treatment, a spontaneous RPE tear can occur in patients with acute and new-onset bullous central serous chorioretinopathy (CSCR). We present a rare case of a healthy young Asian man with unilateral massive subretinal fluid (SRF). An idiopathic acute-onset bullous CSCR with an RPE tear was diagnosed through ancillary examinations. This patient exhibited good visual recovery as indicated by foveal sparing, spontaneous resolution of SRF, and the lack of a need for unnecessary surgery.

Acute onset of deep calcareous degeneration treated with keratoplasty procedures: Two cases report.

There are two types of corneal calcium deposition, one is calcific band keratopathy and another is calcareous degeneration. We report two cases of acute onset of calcareous degeneration after using topical eye drops for their corneal wounds. The calcification in both the cases developed within 1 month. Due to the deeper stromal opacity, calcareous degeneration was impressed. In our cases, the deposits were too deep that they required keratoplasty procedures as better treatment options. One of the cases was treated with penetrating keratoplasty and another case was treated with deep anterior lamellar keratoplasty. Both of our cases had stable corneal grafts, and there were no ocular inflammation and no recurrence of calcification at least for 6 months.

Gender difference in the association between lower muscle mass and metabolic syndrome independent of insulin resistance in a middle-aged and elderly Taiwanese population.

BACKGROUND: Loss of muscle mass was reported to be associated with metabolic syndrome (MetS), but little is known about the gender difference. Thus, the aim of this study was to evaluate the relationship between lower muscle mass and MetS and determine whether there was any gender difference or not. METHODS: A total of 394 middle-aged and elderly Taiwanese adults (138 males and 256 females) were enrolled and completed our health survey. They were stratified into three groups according to appendicular skeletal muscle mass divided by weight. Participants distributed into the lower tertile were defined as people having lower muscle mass. MetS was defined using the Adult Treatment Panel III Asian diagnostic criteria. Multivariate logistic regression analysis was performed to assess the association between muscle and MetS. RESULTS: We found an inverse association between MetS and muscle mass in both males and females. Participants with lower muscle mass had a higher risk of MetS in univariate analysis. The same results were observed when adjusted for age and when also adjusted for living condition factors. However, after additional adjustment for potential confounders and HOMA-IR, we only found it to be statistically significant in the female group (OR in male=3.60; 95% CI=0.62-20.83, p=0.153; OR in female=3.03; 95% CI=1.16-7.94, p=0.024). CONCLUSIONS: We examined the relationship between lower muscle mass and metabolic syndrome in a middle-aged and elderly Taiwanese population. We found that lower muscle mass was associated with the risk of metabolic syndrome in the aged, particularly in females.