International journal of ophthalmology最新文献

Aim: To evaluate the clinical presentation, nasal endoscopic findings, and surgical outcomes of probing surgery (PS) or bicanalicular silicone tube intubation (BCI) performed under nasal endoscopic guidance (NEG) in pediatric patients with congenital nasolacrimal duct obstruction (CNLDO), regardless of previous surgical history.

Methods: This retrospective cross-sectional study included CNLDO patients with data on demographics, fluorescein dye disappearance test (FDDT) results, dacryoscintigraphy findings, prior surgeries, and outcomes of NEG-PS or NEG-BCI. NEG-BCI using Crawford stents was performed intraoperatively in complex cases. Intraoperative and postoperative complications were recorded. Surgical success was evaluated clinically and with FDDT at postoperative months 1 and 6. Stents were retained for a minimum of 12wk, with follow-up for at least 6mo after removal.

Results: Of the 67 pediatric patients (67 eyes, mean age 37.4±17.5mo), 44 (65.7%) were female. Preoperative FDDT was graded 3+ in 85.1% of cases, and dacryoscintigraphy confirmed obstruction in 92.5%. Nine patients (13.4%) had a history of PS. At 6mo, surgical success was achieved in 96.6% (28/29) of the NEG-PS group and 71.1% (27/38) of the NEG-BCI group (P=0.009). All cases with probe exit through the inferior meatus (IM) were successful, whereas exits through the inferior concha (IC) or submucosal IM (SM) were significantly associated with failure (P<0.001).

Conclusion: NEG allows intraoperative classification of CNLDO and selection of surgical method based on real-time anatomical findings. Probe exit through the IM predicts a high likelihood of success, whereas IC or SM exits are risk factors for failure. Incorporating NEG into routine practice may improve surgical precision and reduce the need for repeated procedures.

[This corrects the article DOI: 10.18240/ijo.2026.03.04.].

Aim: To evaluate various corneal topographic patterns in keratoconus (KCN) and their association with disease progression.

Methods: A retrospective cohort study was conducted on 636 eyes of 335 KCN patients (396 males, 240 females) with a mean age of 30.95±7.95y. Participants underwent two ocular examinations, including corneal tomography using the Pentacam-HR. Topographic patterns were classified based on axial curvature, and KCN progression was defined as a change of ≥1.00 D in maximum keratometry (Kmax). Accordingly, evaluated eyes were categorized into progressive, regressive, and stable groups.

Results: The most common topographic pattern was asymmetric bowtie with inferior steepening (AB-IS, 27.4%) in both males (26.8%) and females (28.3%). In the regressive group, asymmetric bowtie with skewed radial axes (21.3%) was most frequent, while AB-IS (31.3%) and inferior steepening (IS, 25.9%) dominated the stable and progressive groups, respectively. Significant differences were observed in corneal parameters across patterns: the oval pattern exhibited the most negative spherical equivalent and the lowest corrected visual acuity, whereas the irregular pattern showed the highest Kmax values in the first examination (P<0.05). The asymmetric bowtie with superior steepening (AB-SS) pattern also exhibited the least curvature. In terms of changes in topographic parameters over time, variations were observed in certain parameters across different patterns. Notably, the irregular pattern exhibited the most significant changes in Kmax between the two examinations. Although the AB-SS tended to regressed, the AB-IS and IS patterns showed a tendency toward progression (P<0.05). Changes in most components of the KCN screening indices also varied significantly across patterns (P<0.05).

Conclusion: Corneal topographic patterns in KCN exhibit distinct characteristics and progression rates. Understanding these patterns can aid in predicting disease progression and tailoring treatment strategies.

Aim: To compare the effect of orthokeratology (OK) and defocus incorporated multiple segment (DIMS) lenses on axial length (AL) elongation in bilateral myopic anisometropic children.

Methods: This retrospective study enrolled bilateral myopic anisometropic children categorized into two groups: OK lenses and DIMS lenses. The eyes with more myopia (MM) were divided into MM eyes and the fellow eyes with less myopia (LM) into LM eyes. According to the myopia degree in MM eyes, the subjects were further assigned to -0.50 to -3.00 D subgroup and -3.25 to -6.00 D subgroup. The t-test was used to analyze the changes in AL elongation between groups and AL differences in both eyes, and the relationship between AL changes and baseline data was evaluated by Pearson linear correlation analysis.

Results: Totally 202 children (8-14y) were divided into OK group with mean age 10.97±1.91y (46 males and 50 females) and DIMS group with mean age 11.05±2.06y (58 males and 48 females). After 1y, the changes of AL in OK-MM eyes (0.14±0.18 mm) were significantly slower than that in OK-LM eyes (0.20±0.19 mm) and DIMS-MM eyes (0.19±0.18; P<0.001, P=0.037). The OK-LM eyes and DIMS-LM eyes, DIMS-MM eyes and DIMS-LM eyes showed no statistically significant difference in AL changes (P=0.337, 0.381). In the -0.50 to -3.00 D subgroups, DIMS-LM eyes had better effect of AL control than OK-LM eyes, the changes of AL in OK-MM eyes and DIMS-MM eyes were no statistically significant. In the -3.25 to -6.00 D subgroups, the results were similar in total group. The change of AL in four subgroups was negatively correlated with age (P<0.05).

Conclusion: OK lens can reduce binocular anisometropia; DIMS lens has similar effect on the control of binocular myopia in children with myopic anisometropia. The OK lenses are more effective than DIMS lenses with higher degrees of myopia, while DIMS lens retard AL elongation more effectively than OK lens when the spherical equivalent refraction of MM eyes is lower than -3.00 D.

Aim: To report on the clinical outcomes of rescuing dislocated Akreos intraocular lenses (IOLs) with a closed continuous-loop suture technique (CCS).

Methods: A retrospective review of patients who underwent CCS for rescuing dislocated IOL between June 2017 and March 2023. The clinical primary outcomes were best-corrected visual acuity (BCVA), intraocular pressure (IOP), IOL positioning, and complications, assessed both preoperatively and for at least 3mo postoperatively.

Results: Nine patients (9 eyes) were reviewed with an average age of 48.67y (range, 18-67y), and a follow-up period averaging 11.67mo (ranging from 3 to 36mo). Post-surgery, the IOLs were well-centered and stable. The preoperative BCVA was 1.03±0.79 logMAR, improving to 0.5±0.48 logMAR at the last follow-up (P<0.05). Preoperative IOP of 20±6.84 mm Hg and postoperative IOP 16.11±5.65 mm Hg (P=0.182). The mean corneal endothelial cell density decreased from 2177±587 to 2080±581 cells/mm² in five patients (P=0.71) and the endothelial cell loss rate is 4.56%.

Conclusion: CCS is an effective, safe, and minimally invasive method for rescuing and stabilizing dislocated Akreos IOLs.

Aim: To evaluate 3% diquafosol ophthalmic solution on ocular surface parameters and the alterations of lipid and muco-aqueous layer in tear film of patients with visual display terminal (VDT)-associated dry eye disease (DED).

Methods: This study included patients with VDT-associated DED. It was a prospective single-arm interventional clinical trial. Patients were provided with 3% diquafosol ophthalmic solution for 3mo and were followed up in 1, 2 and 3mo after treatment. Tear breakup time (TBUT), ocular surface staining score, and ocular surface disease index (OSDI) score were ocular surface characteristics. Lipid layer thickness (LLT), tear meniscus height (TMH), and mucin mRNA expression levels (MUC1, MUC4, MUC5AC, MUC16, and MUC20) were used to measure changes in the tear film. The LipiView interferometer was used to measure the partial blink rate (PBR).

Results: Sixty-eight eyes of 68 participants (54 females; mean age 25.12±4.10y; mean spherical equivalent -4.35±2.69 D) were enrolled. Compared with the pre-treatment, OSDI scores and TBUT improved significantly at all follow-up time points (all P<0.01), and TMH increased significantly at 1 and 3mo (P<0.01, P<0.001, respectively). Conjunctival lissamine green staining improved only at 2mo (P<0.05), while corneal fluorescein staining showed no significant changes. Overall LLT remained unchanged, but the PBR<1 subgroup exhibited significant LLT elevation at 3mo (P<0.05), unlike the PBR=1 subgroup. Conjunctival mRNA expression of MUC1, MUC5AC, MUC16, and MUC20 was significantly upregulated at 1 and 3mo (all P<0.01), and MUC4 expression increased significantly only at 1mo (P<0.001).

Conclusion: In patients with VDT-associated DED, 3% diquafosol ophthalmic solution dramatically reduced symptoms and enhanced tear film stability by promoting ocular surface muco-aqueous secretion. Patients with better blinking habits (PBR<1) demonstrate greater LLT improvement than those with poorer habits.

Aim: To evaluate the corneal biomechanical properties in patients with angioid streaks (AS), and to compare these parameters with those of healthy subjects.

Methods: A retrospective study was conducted, enrolling AS patients and healthy participants as controls. The collected corneal tomographic parameters included flat keratometry, steep keratometry, mean keratometry, maximum keratometry, topographic cylinder value, central corneal thickness, and the total deviation value of the Belin-Ambrósio enhanced ectasia display measured with Pentacam tomography. Corvis ST was used to measure corneal biomechanical parameters, non-contact tonometry intraocular pressure (IOPnct), and biomechanically corrected intraocular pressure (bIOP).

Results: The study comprised 18 eyes from 10 male and 8 female AS patients with a mean age of 48.83±10.66y, and the controls included 31 eyes from 12 male and 19 female healthy participants with a mean age of 47.87±10.69y. All corneal tomographic parameters were comparable between the two groups (all P>0.05), and no corneal ectasia was observed in any AS patient. Compared with the controls, AS patients exhibited statistically significant increases in applanation 1 (A1) time and stiffness parameter A1 (SP-A1), along with significant decreases in applanation 2 (A2) velocity, deformation amplitude (DA), DA ratio (2 mm), and Corvis biomechanical index (CBI; all P<0.05), which indicated higher corneal stiffness in AS. The IOPnct value in AS was significantly elevated, while no significant difference was found in the bIOP value compared to controls (P=0.031 and P=0.095, respectively).

Conclusion: Eyes with AS exhibit normal corneal tomographic characteristics and increased corneal stiffness.

Aim: To investigate the potential impact of lipidaemic and clinical factors on the development of proliferative vitreoretinopathy (PVR) following uncomplicated primary rhegmatogenous retinal detachment (RRD) surgery in nondiabetic individuals.

Methods: This was a retrospective, single-center, case-control study of consecutive patients who underwent primary RRD surgery. The study group comprised 145 patients who developed PVR within 3y of follow-up, while the control group comprised 161 patients with RRD who did not develop PVR. Cox regression analysis was utilized to identify independent associations between various risk markers and the occurrence of PVR.

Results: The mean age of patients was 52.31y (SD=13.29), and 54.25% (n=166) were male. The median time to PVR formation after surgery was 150d. Multivariate Cox regression indicated that cigarette smoking status [hazard ratio (HR): 0.43, 95% confidence interval (CI): 0.31-0.60, P<0.001], retinal detachment (RD) not involving the macula (HR: 0.52, 95%CI: 0.37-0.73, P<0.001), apolipoprotein A1 (ApoA1; HR: 1.01, 95%CI: 1.01-1.02, P<0.001) and apolipoprotein E (ApoE; HR: 3.81, 95%CI: 1.64-8.85, P=0.002) were independent predictors of PVR.

Conclusion: Apart from macular involvement and smoking, the lipidaemic factors ApoA1 and ApoE are risk factors of PVR after primary RRD surgery.