Most ophthalmic surgeries are characterized by small incisions and mild pain, and the surgeries can be conducted under topical anesthesia. 0.4% oxybuprocaine hydrochloride eye drops are one of commonly used topical anesthetics for ophthalmic surgery for its rapid onset and providing sufficient analgesia with long duration. The preservative-free oxybuprocaine hydrochloride unit-dose eye drops have been widely used in ophthalmic clinical practice to speed up turnover of the surgery at present, meanwhile, 0.4% oxybuprocaine hydrochloride eye drops have negligible systemic effects. This article provides a review of the mechanism, analgesia, pharmacokinetics, clinical efficacy, and safety of 0.4% oxybuprocaine hydrochloride eye drops.
Pediatric cataract is a primary blinding eye disease in children worldwide, imposing a substantial financial burden on families and society. With extensive phenotypic heterogeneity, underlying mechanisms of pediatric cataract remain unclear, which restrict more precise and effective treatment of the disease. The emergence of omics technologies has provided powerful tools for exploring the pathogenesis of pediatric cataract. By delineating expression profiles of pediatric cataract across various molecular levels, omics approaches enrich our understanding of the disease's etiological mechanisms, facilitate the identification of novel biomarkers and key pathways, and offer new insights to researchers for the innovative strategies in disease diagnosis and targeted treatments. In this review, we summarize the application of omics approaches in clinical and basic research of pediatric cataract in the past decade, including genomics, transcriptomics, proteomics, and metabolomics. Moreover, current challenges and future perspectives of omics analyses in pediatric cataract studies are discussed.
Objective：General anesthesia with laryngeal mask airway (LMA) is helpful for daytime surgery, however, there are still some concerns about the use of LMA in obese patients.This study retrospectively analyzed the application of LMA in daytime ophthalmic surgery for obese patients.Methods：In this study, 127 patients with a body weight greater than 90kg who underwent daytime eye surgery under general anesthesia at the Ophthalmology Center of Zhongshan University, from January 2021 to March 2024 were included by retrospective analysis.The patients were divided into two groups: overweight group (30>BMI ≥25kg/m2) and obese group (BMI ≥30kg/m2) .The success rate of laryngeal mask airway ventilation and PACU duration were analyzed , and the hemodynamic changes of patients at entry (T1), after induction (T2), after intubation (T3), at the beginning of surgery (T4), 10 minutes after surgery (T5), at the end of surgery (T6), at PACU (T7), and at extubation (T8) were analyzed.Finally, the changes of respiratory parameters in patients with T 3, T 4, T 5, T 6 and T 8 were analyzed.Results：Finally, 127 cases were included for analysis. All patients in the two groups completed the ophthalmic day surgery under the laryngeal mask airway ventilation, no laryngeal mask airway failure cases, the perioperative vital signs of patients in both groups were stable（P>0.05）.Conclusion: General anesthesia with laryngeal mask airway (LMA) can be safely used in daytime ophthalmic surgery for obese patients, but the changes of perioperative respiratory parameters still need to be observed.
Background: Parents often display significant anxiety during the anesthesia evaluation period of pediatric ophthalmic surgery. However, little is known about the precise concerns and its associated risk factors.Methods:During the anesthesia evaluation period, an open questionnaire survey was conducted on 500 parents of children who were planning to undergo ophthalmic surgery.Results:The study found that 65% parents exhibited more anxiety with outcomes of the surgery rather than general anesthesia, and ophthalmic surgery rather than the other types of surgery induced more anxieties in 73% parents. The most frequent concerns for the parents were outcomes of the ophthalmic surgery, operative care by the anesthesiologist, and whether they can pass the pre anesthesia assessment.Importantly, the ages of parents were negatively associated with the most concerns respectively (P<0.05).The most three concerns of parents about general anesthesia were post-operative pain, the emergence time, and duration of anesthesia. There were negatively associations between ages of parents and parental educational background about the concerns of general anesthesia (P<0.05).Meanwhile, the average monthly income of a family is also an important factor affecting anxiety (P<0.05).Conclusions: The outcomes of the ophthalmic surgery, operative care by the anesthesiologist, and whether they can pass the pre anesthesia assessment are the main factors causing parental anxiety,and it is negatively correlated with the age of parents.
Abstract: Objective: Dry eye syndrome is a disease caused by insufficient tear volume, abnormal tear quality, or rapid evaporation of tears, resulting in damage to the surface tissue of the eyeball. Previous clinical treatments for dry eye syndrome mainly focused on relief. As a new technology that has emerged in recent years, the use of intense pulsed laser therapy for dry eye syndrome lacks systematic evaluation of its therapeutic effect and safety. Method: This study searched for randomized controlled trials on the intervention effect of intense pulsed laser therapy on patients with dry eye syndrome from China National Knowledge Infrastructure (CNKI), WanfangData, VIP, and PubMed. The search period was from database establishment to March 2024, and data analysis was conducted using RevMan5.3 software. Result: After analyzing the OSDI score data, it was found that there was no significant difference in the OSDI score data between the two groups of patients treated with intense pulsed laser and other methods for dry eye; Heterogeneity test analysis was conducted on 7 studies, with P<0.1 and I2 ranging from 55%. A random effects model was used for meta-analysis. The meta-analysis results showed that the treatment effect of the study group was significantly better than that of the reference group, and the difference was statistically significant [SMD=0.74, 95% CI (0.60, 0.89), Z=3.08，P=0.002]， The clinical efficacy of intense pulsed laser treatment for dry eye caused by various factors is excellent. Conclusion: Intense pulsed laser therapy has good clinical efficacy and high treatment safety for dry eye syndrome. However, due to the fact that intense pulsed laser is a new technology with limited clinical application, there is limited theoretical support for this study. Therefore, there are few included literature, and a large amount of literature data needs to be supplemented for analysis in the future.
The choroid is a multifunctional, highly vascular, and dynamic tissue which contributes to ocular homeostasis and the regulation of eye growth in both animals and humans. Although challenging to reliably measure, recent advances in ocular imaging (particularly optical coherence tomography) has expanded the current understanding of the role of the choroid in ageing and refractive error development during childhood. This commentary considers recent advances in the field, particularly the impact of orthokeratology on choroidal thickness and contour in myopic children, and the potential use of choroidal metrics as a biomarker for future eye growth.
Objective To assess the causal relationship between coronavirus disease 2019 (COVID-19) and intraocular pressure (IOP) using a two-sample Mendelian randomization (MR) study. Methods Two-sample MR analysis was conducted using summary data from publicly available genome-wide association studies with COVID-19 susceptibility, hospitalization and severity as exposure traits, and IOP as the outcome. The causal relationship between COVID-19 and IOP was examined using the inverse-variance weighted (IVW), weighted median method, and MR-Egger regression. Functional and pathway enrichment analyses were performed to predict potential mechanisms. Results The results of IVW indicated a causal relationship between COVID-19 susceptibility and elevated IOP (β = 0.59, 95% CI: 0.20 ~0.98, P = 0.003). No causal relationship was observed between COVID-19 hospitalization (β = 0.11, 95% CI: -0.20 ~0.24, P = 0.098) or COVID-19 severity (β = 0.06, 95% CI: -0.04 ~0.15, P = 0.234) and IOP. The weighted median and MR-Egger regression supported these findings. Sensitivity analyses indicated no heterogeneity existed based on the Cochran Q test, and there was no horizontal pleiotropy according to the MR-Egger intercept test and MR-PRESSO global test. Enrichment analyses suggest that the mechanism of COVID-19 susceptibility on IOP may be through JAK-STAT signaling pathway, cytokine-cytokine receptor interaction and NOD-like receptor signaling pathway. Conclusion This study highlighted a positive causal relationship between COVID-19 susceptibility and IOP, suggesting that COVID-19 infection may potentially increase the risk of elevated IOP.
Age-Related Macular Degeneration (AMD) is one of the leading causes of blindness in the elderly. Its pathogenesis is complex, involving genetic, environmental, and metabolic factors. Cellular senescence plays a significant role in the onset and progression of AMD. Cellular senescence is a state of permanent cell cycle arrest that occurs after a finite number of cell divisions. Besides its physiological roles in embryogenesis and tissue regeneration, cellular senescence also increases with age, leading to various age-related chronic diseases. This article reviews the biological mechanisms of cellular senescence and its role in AMD, exploring in detail the specific mechanisms by which cellular senescence contributes to the development of AMD. The aim is to provide new insights into the pathogenesis and therapeutic research of AMD.
Ultrasound Cycloplasty (UCP) is a new non-invasive technique for the treatment of glaucoma, which achieve selective coagulation of the ciliary epithelium by means of high-intensity focused ultrasound (HIFU), as well as increases the outflow of aqueous humor in the uveoscleral pathway. Existing studies both at home and abroad have shown that UCP has a good effect of lowing intraocular pressure(IOP), and can be used applied in the treatment of various types of glaucoma. This article summarizes the current literature on the application of UCP for glaucoma, and reviews in terms of the mechanism of action, surgical procedures, indications, efficacy, safety and influencing factors of therapeutic effect, with the purpose to provide reference and basis for clinical application and research.
Objective To quantitatively evaluate the changes of macular function and morphological characteristics and factors associated with prognoses after intravitreal injection of ranibizumab (IVR) on mCNV. Methods This prospective study included 56 eyes of 53 consecutive patients with mCNV who visited Jinan Mingshui Eye Hospital between September 2014 and December 2018. All patients were treated with IVR followed by pro-re-nata (1+PRN) intravitreal injection of ranibizumab and had been follow-up for 24 months. The involved parameters included Best-corrected visual acuity (BCVA), central macular thickness(CMT), greatest linear dimension(GLD), subfoveal choroidal thickness(SFCT) , first kernel response of multifocal electroretinography (mfERG) and chorioretinal atrophy(CRA) , which were measured at baseline, 1 month, 3 months, 6 months, 12 months and 24 months after treatment. Changes of macular function and morphological characteristics and factors associated with prognoses were evaluated. Results The anti-vascular endothelial growth factor (anti-VEGF) treatment revealed improved BCVA, N1 amplitude density and P1 amplitude density of 1-2 ring (P＜0.0001, respectively), significantly decreased CMT, GLD and SFCT 1 month, 3 months, 6 months, 12 months and 24 months after treatment (P＜0.0001, respectively). Final BCVA was associated with baseline BCVA, recurrence, baseline N1 amplitude density of 1-2 ring, and CNV-related chorioretinal atrophy (P＜0.05, respectively); Final GLD was associated with baseline GLD and recurrence (P＜0.01, respectively). The progress of CNV-related chorioretinal atrophy was associated with baseline GLD and recurrence (P＜0.05, respectively). Recurrence was associated with baseline GLD (P＜0.05); Number of injections was associated with recurrence (P＜0.001). Conclusion Ranibizumab significantly improved macular function in treating patients with mCNV. Visual function and anatomical prognoses were influenced by multiple factors.
