With the continuous advancement of corneal disease treatment technology, Bowman layer transplantation (including Inlay and Onlay technology) has become an important means for the treatment of advanced progressive keratoconus, which can effectively improve the corneal topography and visual acuity of patients, stabilize corneal dilation, and improve the quality of life of patients. Tis article reviews the theoretical basis of Bowman layer transplantation, the source and preparation of grafs, surgical techniques, clinical efcacy, and related complications, which provides a new perspective for the treatment of advanced keratoconus. It is stated in the research that this advanced transplantation technique has significant advantages over traditional methods in reducing surgical risks, simplifying the surgical procedures, and improving postoperative recovery. Especially in reducing the risk of allograft rejection and surgical complications, the bowman layer transplantation performs excellently. As a novel developed method, Onlay technology has the unique advantage of eliminating the need to dissect the cornea, which beter protects the corneal structure. In addition, due to the highly adaptable and reversible nature of this technique, it provides patients with more treatment options and beter visual recovery. However, in terms of technical details such as customizing the size and shape of the transplant, optimizing the surgical depth, etc., it is needed to conduct further research and optimization to improve the overall treatment efect.
Patients with low vision are severely impaired in visual function due to different ocular and neurological disorders,which have a serious impact on their daily activities (such as reading and driving), quality of life and mental health.People's perception of external information mainly comes from vision. Expect for the life-threatening major diseases,visual damage has the greatest impact on people's senses. With the ageing of the population, the problem is getting worse, and low vision has become a serious public health problem in the world. Currently the development of low vision rehabilitation is facing a huge challenge in clinical and scientific research, to develop a visual impairment assistance technology that can effectively improve visual function while balancing multiple functions. It requires the joint development and cooperation of multiple disciplines such as medicine, biology, engineering, microelectronics, and computer science. Low vision rehabilitation provides patients with appropriate visual impairment assistance technology,maximizing the use of residual vision and visual function of patients, improving the functional limitations associated with low vision, effectively improving their independence and overall quality of life, and makes it possible for them to live, work and integrate into the society independently. This article reviews the progress in the application on visual impaired assistive technologies such as classic visual aids, artificial vision (visual prostheses/visual sensory replacement devices), transcranial stimulation and visual biofeedback training in low vision rehabilitation.
Objective: To investigate the expression level of T-box transcription factor 2(TBX2) in uveal melanoma (UVM), the correlation between survival prognosis and immune infiltration. Methods: The expression and clinical features of TBX2in normal and tumorwere analyzed by TIMER2.0 database. The survival data of pancarcinoma were downloaded from UCSC Xena database, and the prognotic value of TBX2 was evaluated using Cox proportional risk model and Kaplan-Meier curve analysis. Then cBioPortal database was used to analyze the changes before and after TBX2 mutation survivalin human, and BloodSpot and TIMER2.0 databases were used to explore the correlation between TBX2 and cancer immune infiltration. Cancer single cell status mapping and gene set variation analysis (GSVA) were used to explore the correlation between its expression and molecular mechanisms. Results: The mRNA expression levels of TBX2 were significantly changed in 15 tumor types. TBX2 is adrenocortical carcinoma (ACC) and kidney renal papillary cell carcinoma (Kidney renal papillary cell carcinoma). KIRP and UVM are typical prognostic markers of survival. The mutation had no significant correlation with survival status, and increased T cell infiltration level in UVM led to increased risk of poor prognosis. In addition, the TBX2 pathway is enriched to the ATP-binding cassette transporter (ABC) transporters, DNA repair, and damage in UVM. Conclusion: TBX2 plays a key role in survival and immune invasion of uveal melanoma.and may be used as a predictor of UVM prognosis and immunotherapy effect in thefuture.
Objective: To compare the effects and distinctions among three methods of phacoemulsification training: EYESi simulator (Dry-lab), Wet-lab, and a combined approach, in order to find out more scientific and efficient teaching method. Methods: 18 first-year residents undergoing residency training at Zhongshan Ophthalmic Center, Sun Yatsen University were randomly assigned to three groups: Dry-lab, Wet-lab, and Combined. Each group, consisting of 6 individuals, underwent a specific training regimen—8 sessions of effective simulator training for the Dry-lab group, 8 Wet-lab sessions for the Wet-lab group, and a combination of 4 effective simulator sessions with 4 Wet-lab sessions for the Combined group. The questionnaires were administered to assess simulation effects and student satisfaction before and after each training sessions. Additionally, the training effects were recorded in the three main steps of phacoemulsification cataract extraction surgery on a pig eye model. Results: Both the EYESi simulator and Wet-lab were proved to be effective in facilitating the learning of microscopic instrument use with commendable operating experience. However, Wet-lab is superior to the virtual simulator in terms of stereoscopic sensation (P=0.007), similarity to the human eye (P<0.001), and assistance in mastering techniques(P=0.003). Simulator training is found to be more advantageous in shortening the overall training time (P<0.001). The training effect of the joint training mode is better than that of single Wet-lab training (P=0.014) and simulator training (P=0.012), and the overall satisfaction is higher than that of Wet-lab training (P=0.042) and simulator training (P=0.042). Conclusion: The EYESi virtual surgery simulator and Wet-lab training have their advantages respectively in training for phacoemulsification cataract extraction microsurgery, and the combined teaching mode is more efficient, with better training effects and overall satisfaction.
Objective: To investigate the relative risk of pretransplant corneal vascularisation on rate of rejection and graft failure within 5 years of surgery when categorised by indication for transplantation. Methods: We analysed all adults recorded in the UK transplant registry who had a first cornea transplant for keratoconus (KC), pseudophakic bullous keratopathy (PBK) or previous infection (viral/bacterial/fungal/protozoan) between 1999 and 2017. We analysed the number of quadrants of the recipient cornea vascularised before transplant and type of vascularisation, the interval posttransplant to rejection, if any, and the outcome at 5 years post-transplant. Risk factors for rejection and transplant failure were modelled by multivariable risk-adjusted Cox regression. Results: Corneal vascularisation was recorded in 10%, 25% and 67% of patients with KC, PBK and infection, respectively. Individuals with PBK had an increased hazard of transplant rejection only when there were more than two quadrants of vascularisation (HR 1.5, p=0.004) when either superficial and/or deep vascularisation was present (HR 1.3 and 1.4, respectively, p=0.004). Individuals who had a transplant for previous infection had an increased hazard of rejection with four quadrants of vascularisation (HR 1.6, p=0.003). There was no risk-adjusted increase in transplant failure associated with vascularisation in any group. There was weak evidence of reduction in risk of rejection and/or failure associated with lamellar compared with penetrating transplantation in KC and PBK in vascularised recipient corneas. Conclusion: Vascularisation is a risk factor for corneal allograft rejection within 5 years. The indication for transplantation has a clinically significant effect on the magnitude of this risk.
Objective: To compare the difference of visual function among children with myopia in different diopter, and explore the effect of short-term plastic training of virtual reality on visual function improvement. Methods: The 102 children aged 6-16 years who admitted to Children's Hospital of SoochowUniversity from June 2022 to September 2022 were recruited and divided into control group, mild myopia group and middle and high myopia group according to diopter. Routine ophthalmologic examination and visual perception function examination were carried out, and short-term plastic training was implemented. After the training, visual perception function examination was completed again. Results: There were significant differences in stereoscopic function defect at different distances among myopic children, a negative correlation between myopia and stereoscopic function was found. while there were several cases have foveal suppression. After training, the fine stereopsis at medium distance of the mild myopia group was significantly improved with significance statistical difference. Conclusions: Myopia can lead to the abnormality of stereopsis and foveal suppression in children. The defect of binocular visual function increases with the increase of myopia. Short term plastic training of virtual reality can partially improve the fine stereoscopic function of mild myopia children whileshowsnosigni ficanceimprovementof the fine stereoscopic function in middle and high myopia group.
Fungal corneal ulcer is an infectious corneal disease with a high risk of blindness, and early diagnosis and treatment are particularly important for the prognosis of patients. Corneal scraping microscopy can assist in the diagnosis of fungal keratitis, while corneal scraping fungal culture is the gold standard for diagnosing fungal keratitis. This article reports a case of fungal keratitis caused by the rare fungus Sarocladium. Through the combination of corneal laser scanning confocal microscopy and corneal ulcer scraping fungal culture, the diagnosis of Sarocladium keratitis was confirmed by the rapid identification of mass spectrometer, and intimately fungal treatment was carried out, The patient's prognosis was good. Based on this, the diagnostic methods for Sarocladium keratitis are summarized in order to provide new ideas for the clinical diagnosis of rare fungal genera.
Fungal corneal ulcer is an infectious corneal disease with a high risk of blindness, and early diagnosis and treatment are particularly important for the prognosis of patients. Corneal scraping microscopy can assist in the diagnosis of fungal keratitis, while corneal scraping fungal culture is the gold standard for diagnosing fungal keratitis. This article reports a case of fungal keratitis caused by the rare fungus Sarocladium. Through the combination of corneal laser scanning confocal microscopy and corneal ulcer scraping fungal culture, the diagnosis of Sarocladium keratitis was confirmed by the rapid identification of mass spectrometer, and intimately fungal treatment was carried out, The patient's prognosis was good. Based on this, the diagnostic methods for Sarocladium keratitis are summarized in order to provide new ideas for the clinical diagnosis of rare fungal genera.
Myopia has become an important public health problem worldwide, and more and more studies have focused on the effects of light on myopia, with light intensity, light wavelength, light frequency and rhythm all influencing the refractive development of the eye. In this paper, we summarize the relationship between different light environments and myopia and their mechanisms of action, with a view to providing new ideas for the prevention and control of myopia.
Purpose: To investigate the effects of surgical intervention on visual function and quality of life in patients with orbital fractures. Methods: We retrospectively analyzed the clinical data of 180 patients with orbital fractures treated at our hospital from January 2021 to December 2022. Based on different treatment modalities, patients were divided into a conservative group (mainly corticosteroid conservative treatment) and a surgical group (surgical intervention). Propensity score matching was used to balance covariates between the two groups. After matching, each group had 36 patients. Visual acuity levels before and after treatment and Short Form-36 Health Survey (SF-36) scores were compared between the two matched groups. Adverse reactions and complications were also recorded. Results: After treatment, the surgical group had higher SF-36 scores than the conservative group in physical functioning (79.58±8.14 vs 75.32±7.46), social functioning (78.28±7.96 vs 73.31±6.80), role-physical (79.30±7.80 vs 74.12±7.96), mental health (78.82±7.62 vs 73.46±7.50), bodily pain (78.42±6.40 vs 73.10±6.25), role-emotional (79.85±6.85 vs 74.76±6.30), vitality (78.90±6.92 vs 73.32±6.50), and general health (79.14±6.85 vs 72.76±6.60). The differences between the two groups were statistically significant (t=2.315, 2.848, 2.789, 3.008, 3.568, 3.282, 3.526, 4.024; P=0.024, 0.006, 0.007, 0.004, 0.001, 0.002, 0.001, 0.001). The incidence of adverse reactions and complications was 5.56% in the surgical group and 8.33% in the conservative group, with no significant difference between the two groups (χ2=0.215, P=0.643). Conclusions: Surgical intervention can improve visual function and quality of life in patients with orbital fractures, and is worth adopting.
