Effect of pupil dilation on biometry measurements and intraocular lens power in eyes with high myopia.

Purpose: The present study sought to evaluate the effects of pupil dilation on ocular parameter measurements and intraocular lens (IOL) power calculation using IOLMaster in highly myopic cataract patients. Materials and methods: A total of 233 eyes were included in this prospective study and assigned to four groups based on range of axial length (AL) as follows: group A:26-28 mm, group B:28-30 mm, group C:30-32 mm, and group D:32-36 mm. Flattest and steepest keratometry (K1 and K2), AL, anterior chamber depth (ACD), lens thickness (LT), and white-to-white (WtW) were determined using IOLMaster before and after administration of topical tropicamide. The corresponding IOL powers were calculated using Sanders-Retzlaff-Kraff/theoretical (SRK/T), Haigis, and Barrett Universal II formulas. Results: Variations in AL, K1 and K2 following dilation were not significant (P > 0.05 in all groups). The results showed that ACD increased significantly after dilation (P = 0.000 in all groups), whereas LT decreased significantly after dilation (P = 0.000, 0.000, 0.001, and 0.003). Post-dilation WtW increased significantly in Group A, B, and C (P = 0.001, 0.001, and 0.025) but not in Group D. When IOL power was calculated as a discrete variable, significant differences were observed between pre- and post-dilation IOL power. Conclusion: Pupil dilation in cataract eyes with high myopia does not cause significant changes in AL and K. However, it significantly increases ACD as well as WtW values and significantly decreases the LT value. Surgeons should evaluate the effect of pupil dilation on IOL power prediction as the present findings show extreme cases. Notably, Barrett Universal II formula had the best concordance between different pupil conditions in long eyes.

Paeoniflorin inhibits epithelial mesenchymal transformation and oxidative damage of lens epithelial cells in diabetic cataract via sirtuin 1 upregulation.

Paeoniflorin (Pae) has been reported to serve an important role in complications associated with diabetes. To the best of our knowledge, the role of Pae in diabetic cataracts has not yet been reported. Human lens epithelial SRA01/04 cells were induced by high glucose (HG) and subsequently treated with Pae. Cell viability was detected using the MTT assay. Moreover, LDH levels were detected. Immunofluorescence (IF) and Western blotting were used to determine the protein expression levels of N-cadherin and E-cadherin. ELISA was performed to determine oxidative stress-related indicator levels. TUNEL and Western blotting detected the apoptotic rate. The mRNA and protein expression levels of sirtuin 1 (SIRT1) in SRA01/04 cells were measured via reverse transcription-quantitative PCR and Western blotting, respectively. Subsequently, cell transfection techniques were used to inhibit the expression of SIRT1 in cells. MTT, ELISA, IF, Western blotting and TUNEL assays were used to investigate the mechanisms of epithelial-mesenchymal transition (EMT) and oxidative damage with Pae in the diabetic cataract. Pae significantly increased cell viability and possibly inhibit the EMT and oxidative damage of SRA01/04 cells induced by HG. Pae was demonstrated to upregulate SIRT1 expression levels. The results therefore suggested that the downregulation of SIRT1 reversed the protective effect of Pae on EMT and oxidative damage in SRA01/04 cells induced by HG. In conclusion, Pae may inhibit EMT of lens epithelial cells and reduce oxidative damage in diabetic cataracts via the upregulation of SIRT1.

Measures to improve the comfort of cataract surgery patients: a systematic review and meta-analysis.

BACKGROUND: Improving patient comfort can provide patients with a better experience during surgery and reflect the high-quality of hospital medical services. This study conducted a systematic review and meta-analysis of several recent academic reports on improving patient comfort in cataract surgery to provide a guide for clinical diagnosis and treatment. METHODS: PubMed, Embase, and Web of Science were searched for reports on measures to improve the comfort of cataract patients. The retrieved reports were for randomized controlled studies published after January 2000. They were selected by two researchers and evaluated using the Jadad scale. The reports were then grouped according to the interventions used in the studies. Stata 16.0 software (StataCorp, TX, USA) was used to analyze the improvement noted with each intervention. RESULTS: Nineteen reports were included in this review, covering a total of 3,378 patients with cataract surgery. Results showed that the implementation of high-quality nursing techniques could reduce postoperative pain [standard mean difference (SMD) =-1.19; 95% confidence interval (CI): -1.96 to -0.43; P=0.002], the use of anxiolytic drugs (melatonin) could reduce postoperative anxiety in cataract patients (SMD =-0.55; 95% CI: -0.95 to -0.15; P=0.007), and there was no significant difference in the topical anesthetic drugs used to improve patient comfort [odds ratio (OR) =0.66; 95% CI: 0.31 to 1.40; P=0.276]. DISCUSSION: During the perioperative period of cataract surgery, high-quality nursing techniques (preoperative video and audio education, limb massage or back massage, listening to soothing music) can reduce pain and anxiety. Anti-anxiety agents and preoperative sedatives can alleviate anxiety and improve comfort, but they are suitable for patients with high anxiety. What kind of surface anesthetic drugs are used in operation has no obvious help to improve comfort.