The tolerance of refractive errors of extended depth of focus intraocular lens in patients with previous corneal refractive surgery.

PURPOSE: To evaluate the tolerance for refractive errors and visual outcomes of extended depth of focus intraocular lens (EDOF IOLs) in patients with previous corneal refractive surgery for myopia. METHODS: Patients from Aier Eye Hospital of Wuhan University with previous myopia excimer laser correction underwent cataract surgery and implantation of an EDOF IOL. The follow-up period was three months. The uncorrected distance, intermediate, and near visual acuities (UDVA, UIVA, UNVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), defocus curve, optical quality, including modulation transfer functions (MTF) and Strehl ratio (SR), National Eye Institute Visual Functioning Questionnaire-14 for Chinese people (VF-14-CN), spectacle independence, and dysphotopsia were assessed. RESULTS: At the final visit, UDVA, CDVA, UIVA, and UNVA (LogMAR) were 0.06 ± 0.09, 0.01 ± 0.06, 0.11 ± 0.08, 0.20 ± 0.10, respectively. The mean spherical equivalent (SE) was - 0.57 ± 0.58D, sphere and cylinder were - 0.24 ± 0.60D, - 0.70 ± 0.58D respectively. No statistical difference in UDVA between eyes with SE in ± 0.50 D and in ± 1.0 D (p > 0.05). Corneal astigmatism > 1.00D has no significant effect on postoperative visual acuity (p > 0.05). The defocus curve showed that visual acuity could reach 0.2 in the refractive range of + 0.50D ~ - 1.50D. SR and MTF values were all higher than before the surgery. In bilateral implantation patients, the VF-14-CN questionnaire score and visual quality were quite excellent. CONCLUSION: The EDOF IOL have a certain tolerance for refractive errors and corneal astigmatism, and it's recommended for patients with prior myopia excimer laser surgery to achieve satisfactory visual performance.

Characteristics and influencing factors of corneal higher-order aberrations in patients with cataract.

PURPOSE: To observe the distribution characteristics of corneal higher-order aberrations (HOAs) in cataract patients, and analyze the relationship of HOAs with patients' age and ocular biometric parameters. METHODS: This retrospective study reviews the patients with cataract in Wuhan Aier Eye Department from January to August 2022. Root mean square (RMS) of the total HOA (tHOA), spherical aberration (SA), coma and trefoil aberration of the anterior cornea at central 4 and 6 mm optic zone were measured by the Wavefront Aberrometer (OPD-Scan III; Nidek Inc, Tokyo, Japan). The biometric parameters including axial length (AL), keratometry (K), central corneal thickness (CCT) and lens thickness (LT) were measured by swept-source coherence laser interferometry (OA-2000; TOMEY Corp, Aichi, Japan). Subgroup analyses and multiple linear regression analyses were used to determine whether HOAs were associated with age and ocular biometric parameters. RESULTS: A total of 976 patients (976 eyes) were included, averagely aged 65 years. At central 4 and 6 mm optic zone, the mean RMS of tHOA were respectively 0.20 and 0.65 µm, the SA were 0.06 and 0.30 µm, the coma aberration were 0.11 and 0.35 µm, and the trefoil aberration were 0.12 and 0.30 µm. The tHOA decreased with age until 60 years and then started to increase afterwards. The tHOA, coma and trefoil aberration increased with corneal astigmatism. The tHOA, SA, and coma aberration differ among different AL groups, and emmetropes had the smallest tHOA, SA, and coma aberration. CONCLUSIONS: With increasing age, the value of tHOA decrease first and started increasing at 60 years. The trends of corneal HOAs are consistent with corneal low-order aberrations. The values of tHOA, SA and coma aberration were the smallest in emmetropic eyes.

Prediction accuracy of no-history intraocular lens formulas for a diffractive extended depth-of-focus intraocular lens after myopic corneal refractive surgery.

PURPOSE: To compare the accuracy of intraocular lens (IOL) calculation methods for extended depth-of-focus (EDoF) IOLs in eyes with a history of myopic laser-assisted in situ keratomileusis (LASIK)/photorefractive keratectomy (PRK) surgery lacking historical data. SETTING: Changsha Aier Eye Hospital, Changsha, and Wuhan Aier Eye Hospital, Wuhan, China. DESIGN: Retrospective case series. METHODS: Patients with axial lengths (ALs) ≥25.0 mm and a history of myopic LASIK/PRK surgery who underwent cataract surgery with implantation of EDoF IOLs were enrolled. A comparison was performed of the accuracy of 10 IOL methods lacking historical data, including Barrett True-K no history (Barrett TKNH), Haigis-L, Shammas, and Potvin-Hill formulas and average, minimum, and maximum IOL power on the ASCRS online postrefractive IOL calculator; Seitz/Speicher/Savini (Triple-S) formula; and Schuster/Schanzlin-Thomas-Purcell (SToP) formulas based on Holladay 1 and SRK/T formulas. IOL power was calculated with the abovementioned methods in 2 groups according to AL (Group 1: 25.0 mm ≤ AL < 28.0 mm and Group 2: AL ≥ 28.0 mm). RESULTS: 64 eyes were included. Excellent outcomes were achieved with the minimum, Barrett TKNH, SToP (SRK/T), and Triple-S formulas in the whole sample and subgroups, which led to similar median absolute error, mean absolute error, and the percentage of eyes with a prediction error within ±0.5 diopters (D). In the whole sample, the Haigis-L and maximum formulas had a significantly higher absolute error than minimum, SToP (SRK/T), and Barrett TKNH formulas. The maximum formula also had a significantly lower percentage of eyes within ±0.5 D than the Barrett TKNH, and SToP (SRK/T) formulas (15.6% vs 50% and 51.5%, all P < .05 with Bonferroni adjustment). CONCLUSIONS: Predicting the EDoF IOL power in postmyopic refractive eyes by no-history IOL formulas remains challenging. The Barrett TKNH, Triple-S, minimum, and SToP (SRK/T) formulas achieved the best accuracy when AL ≥ 25.0 mm, while the Barrett TKNH and SToP (SRK/T) formulas were recommended when AL ≥ 28.0 mm.

Protective effect of resveratrol on lens epithelial cell apoptosis in diabetic cataract rat.

OBJECTIVE: To study the protective effect of resveratrol on lens epithelial cell apoptosis in diabetic cataract rat. METHODS: A total of 84 Wistar rats were divided into 4 groups: 12 in Group A (control group), 24 in Group B (diabetic cataract group), 24 in Group C (therapeutic-dose of resveratrol group) and 24 in Group D (low-dose of resveratrol group). Rats in Group B-D were given with 60 mg/kg streptozotocin through intraperitoneal injection. Rats in Group C were given with 100 mg/kg resveratrol and rats in Group D were given with 20 mg/kg resveratrol. The caspase-3 expression levels and apoptosis ratios of LEC among each group were observed; the degrees of lens opacity in Group B-D after 12 weeks were compared. RESULTS: There were significant differences in caspase-3 expression levels, apoptosis ratios of LEC among groups at 4 w, 8 w and 12 w (P<0.05). After 12 weeks, in Group B the degree of lens opacity was as follow: 0 (0.00%) in grade I, 3 (37.50%) in grade II, 2 (25.00%)in grade III, 2 (25.00%)grade IV, and 1 (12.50%) in grade V; in Group C: 2 (25.00%)in grade I, 4 (50.00%) in grade II, 2 (25.00%)in grade III, 0 (0.00%)grade IV, and 0 (0.00 %) in grade V; in Group D: 1 (12.50%)in grade I, 4 (50.00%) in grade II, 2 (25.00%) in grade III, 1 (12.50%) grade IV, and 0 (0.00%) in grade V. The difference among Group B-D was statistically significant (P<0.05). CONCLUSIONS: Resveratrol has protective effect on lens epithelial cell apoptosis in diabetic cataract rat, and the effect is relative to its dose.