Purpose: To compare the consistency between the recommended size of Implantable Collamer Lens (ICL) by Staar Company and the actual size implanted, and to evaluate the difference between the actual vault and the predicted vault using the N-K formula. Method: This was a retrospective study involving patients who underwent phakic intraocular lens implantation surgery at our hospital between 2022 and 2023. A total of 100 eligible patients were included in the study. Data of the right eye was selected, and postoperative follow-up was conducted for 3 months to assess the agreement between the implanted ICL size and the recommended size by Staar's nomogram. The actual vault was measured at 1 day, 1 week, 1 month, and 3 month postoperatively using anterior segment optical coherence tomography (CASIA 2, Tomey) and compared with the predicted vault using the N-K formula. Results: The consistency rate between the implanted ICL size and the recommended ICL size by Staar’s nomogram was 59.0%. There was no significant difference between the postoperative 1-day vault (590.92±145.33μm) and the N-K formula predicted vault (570.21±192.31μm). However, the postoperative 1-week vault (518.57±126.72μm),1-month vault (507.08±126.10μm), and 3-month vault (492.66±119.395μm) showed significant differences compared to the N-K formula predicted vault(p<0.01).When selecting an ICL size of 12.1mm, there was no significant difference between the postoperative 3-month vault and the N-K formula predicted vault (p=0.507). On the other hand, when opting for ICL sizes of 12.6mm and 13.2mm, the postoperative 3-month vault was significantly smaller than the N-K formula predicted vault (p<0.01). Conclusion: The concordance rate between the implanted ICL size and the ICL size recommended by Staar Company was approximately 59%. The postoperative vault gradually decreases over time. The actual vault was more consistent with the vault predicted by the N-K formula in the early postoperative period, . By the 3 month postoperatively, the vault predicted by the N-K formula was significantly higher than the vault achieved, especially when larger ICL sizes are selected. However, there is no significant difference in selection of a 12.1mm ICL size between the predicted vault and the postoperative vault
Congenital cataract is one of the leading causes of treatable childhood blindness. The existing classification systems of congenital cataracts are mainly used for clinical and molecular diagnosis of the disease. Limited information was provided by the current classification systems, which was needed for the evaluation, formulation, and optimization of treatment plans. Moreover, research on the classification of congenital cataracts still needs exploration to provide further evidence supporting molecular diagnosis and syndromic disease diagnosis. The relevant studies on the classification of congenital cataracts were reviewed, and the prospects of research on the classification of congenital cataracts were discussed.
Aims: Divided nevus of the eyelid is a congenital pigmented nevus that impacts eyelid function and aesthetics. While surgical excision and laser ablation are current treatment options, they have limitations when dealing with large lesions. This study aims to investigate the efficacy and safety of carbon dioxide (CO2) laser excision treatment for divided nevus of the eyelid. Methods: This retrospective study included 10 patients (5 males, 5 females) with a mean age of 23.7 years (9-54 years). All underwent CO2 laser excision and were followed up for 12 months. Treatment outcomes were assessed through clearance and recurrence rates, evaluated using digital photography. Postoperative complications were closely monitored throughout the 12-month follow-up period. Patient satisfaction was assessed using a comprehensive questionnaire. Results: All patients presented with unilateral divided nevus of the eyelid, with lesion diameters ranging from 25 to 50 mm and heights ranging from 0.3 to 6 mm (mean: 3.93 mm). Patients received between 1 and 5 laser treatment sessions. At the 12-month follow-up, a 100% clearance rate was achieved, with no recurrence observed in any patient. All patients maintained a continuous eyelid margin with acceptable irregularity. Complications were minimal, with partial eyelash loss in 8 patients, hyperpigmentation in 2 patients, and mild upper eyelid trichiasis in 1 patient. No severe complications, such as ectropion, eyelid margin notching, corneal erosion, or significant scar hypertrophy, were reported. All patients expressed being "very satisfied" with the functional and cosmetic outcomes in a questionnaire. Conclusions: CO2 laser excision offers a simple, precise, and effective treatment approach for divided nevus of the eyelid. This innovative technique simplifies the treatment process, achieves excellent cosmetic outcomes, and eliminates the need for skin grafting, making it a promising option for the management of large divided nevus.
Objective To analyze the visual screening of 0-6 year old children in Putian city, delay the depletion of far-sighted reserve, advance the threshold of myopia prevention and control, and reduce the incidence of myopia in children. Methods From January 2024 to May 2024, a total of 1946 children aged 0-6 years who were treated in the Child Health care Department of Putian Maternal and Child Health Hospital were screened by vision screening instrument and the results were analyzed. Results A total of 1946 children underwent vision screening, among which 366 children had abnormal refraction, the abnormal rate was 18.81%, the abnormal rate was 24.58% in 6-November age group, 12.20% in 12-35 month age group, and 14.57% in 3-6 year age group. Astigmatism was the most common type of abnormal refraction. The equivalent spherical mirror of 6-11 months group was significantly different from 12-35 months group and 3-6 years old group, respectively. The incidence of refractive abnormalities in children of different sex, age and place of residence was statistically significant. Conclusion The overall visual acuity development of 0-6 year old children in our city is not optimistic. It is necessary to strengthen the publicity and education of visual acuity care and guide parents and children to develop good living habits in order to prevent and intervene the abnormal visual acuity in time.
Objective To analyze the visual screening of 0-6 year old children in Putian city, delay the depletion of far-sighted reserve, advance the threshold of myopia prevention and control, and reduce the incidence of myopia in children. Methods From January 2024 to May 2024, a total of 1946 children aged 0-6 years who were treated in the Child Health care Department of Putian Maternal and Child Health Hospital were screened by vision screening instrument and the results were analyzed. Results A total of 1946 children underwent vision screening, among which 366 children had abnormal refraction, the abnormal rate was 18.81%, the abnormal rate was 24.58% in 6-November age group, 12.20% in 12-35 month age group, and 14.57% in 3-6 year age group. Astigmatism was the most common type of abnormal refraction. The equivalent spherical mirror of 6-11 months group was significantly different from 12-35 months group and 3-6 years old group, respectively. The incidence of refractive abnormalities in children of different sex, age and place of residence was statistically significant. Conclusion The overall visual acuity development of 0-6 year old children in our city is not optimistic. It is necessary to strengthen the publicity and education of visual acuity care and guide parents and children to develop good living habits in order to prevent and intervene the abnormal visual acuity in time.
Aim: To investigate the clinical features and surgical outcomes of divergence insufficiency pattern in patients with acute acquired comitant esotropia (AACE). Methods: Medical records of AACE patients with deviation measured by prism and alternative cover test (PACT) larger at distance than at near by 10△ or more were retrospective reviewed. The preoperative and postoperative deviations and sensory functions were investigated. The preoperative deviations were measured by three methods, include PACT, maddox rod and prism test (MRPT) and base-out recovery point (BORP). The surgical target angle was based on the BORP. Results: Thirteen patients underwent medial rectus recession (MRc) or recession combined with resection (RR) were included. The mean preoperative deviation at distance and near was 25.4±6.3△ and 14.5±6.5△ with PACT, 30.0±6.2△ and 21.9±6.3△ with MRPT, 33.5±5.6△ and 32.8±5.6△ with BORP. The deviation measured by MRPT was larger than PACT at near (P=0.004). The deviation measured by BORP was larger than PACT both at distance (P=0.002) and near (P<0.001). Moreover, the deviation measured by BORP was larger than MRPT at near (P<0.001). All patients with decreased near stereoacuity displayed recovery after surgery. At the final follow-up, the mean deviation was 0.6±0.9△ at distance and 0.7±1.9△ at near. Conclusions: The deviation increased in AACE patients with divergence insufficiency pattern when different measurements were used. The procedures of MRc or RR presented favourable outcomes based on the BORP as the surgical target angle.
Objective To improve the efficiency of bandage handover and reduce the error rate of eye bandage for patients under general anesthesia in our hospital by applying the quality control circle management method. Methods Different bandage signs were designed according to the surgical procedure, and the shift was handed over by the operating room nurse and the anesthesia nurse in the PACU. Results Through the quality control circle activities, the correct rate of bandage dressing was significantly improved, the target achievement rate was 98%, and the bandage process was optimized. Conclusion The quality control circle management method has further optimized the bandage dressing process for patients under general anesthesia in our hospital, improved work efficiency, and provided better protection for clinical medical safety.
Marfan Syndrome (MFS) is a systemic genetic disorder caused by mutations in fibrillin-1 (FBN-1), which can lead to ocular pathologies including ectopia lentis, corneal flattening, refractive status abnormalities, and retinal abnormalities, which can affect patients with MFS with altered visual acuity. Therefore, clarifying the pathogenesis of MFS and understanding the characteristics of MFS ocular pathology and its impact on vision are important for the future development of treatment plans for MFS ocular disease. The exact pathogenesis of MFS ocular anomalies is still unclear. Mouse models suggest that dysfunctional fibrillin-1 glycoproteins lead to ultrastructural disruption of elastic and collagen fibers, which in turn leads to keratoconus and lens subluxation. In patients with ocular abnormalities of MFS, refractive errors are mainly corrected by surgery or prescription treatment to improve patients' visual acuity. This article provides a review of the relevant advances.
Purpose: The aim of this study is to analyze and summarize the diverse ocular manifestations in probands with pathogenic or likely pathogenic (P/LP) variants in NF1 and NF2. Methods: Variants in NF1 and NF2 were selected from in-house exome sequencing and whole genome sequencing of individuals with different eye conditions. P/LP variants were assessed by multiple bioinformatic tools, Sanger sequencing confirmation, co-segregation analysis, and finally classified based on ACMG/AMP criteria. All the available clinical data were summarized and further analyzed. Results: A total of ten P/LP variants in NF1 and NF2 were identified in 11 unrelated cases with various eye conditions, including three NF2 variants in four cases and seven NF1 variants in seven cases. The four patients with NF2 variants had clinical presentations similar to familial exudative vitreoretinopathy (FEVR), and macular or retinal dystrophy at the initial visit. After the identification of NF2 variants, a follow-up examination on two of the four identified typical retinal changes of NF2, including epiretinal membrane (ERM) and retinal hamartoma. Interestingly, one case had complicated ocular phenotypes (ERM plus retinal hamartoma, retinoschisis, and congenital stationary night blindness) due to pathogenic variants in three genes (NF2, RS1, and NYX) as well as bilateral vestibular schwannomas, spinal ependymoma and multiple schwannomas associated with NF2 variants. Of the seven cases with NF1 variants, five with signs and symptoms mimicking strabismus, FEVR, retinitis pigmentosa, Coats disease, and morning glory syndrome, respectively, while the remaining two had typical optic nerve glioma with histopathological confirmation. Café-au-lait macules or freckling were not noticed by the patients or ophthalmologists, but such skin changes were actually present in four of the seven cases on follow-up examination, which could be easily neglected if neurofibromatosis is not realized on the initial visit. Conclusions: This study extends the spectrum of ocular phenotypes of NF. Variable ocular changes may present as the initial sign of neurofibromatosis. Awareness of such association, combined with visualization of skin, systemic MRI scan, and gene test, may be helpful in the diagnosis of such diseases and facilitate early identification of vital systemic complication.
