Objective: To evaluate the clinical safety and curative effect of phacoemulsification (Phaco) combined with multifocal intraocular lens (MIOLs) implantation in the treatment of senile cataract with 2.2 mm microincision cataract. Methods: The cataract patients who underwent phacoemulsification and intraocular lens implantation in our hospital were selected from January 1, 2018 to June 31, 2018. They were divided into two groups: group A with 31 patients (35 eyes) undergoing 2.2 mm micro-incision Phaco combined with MIOLs, while group B with 31 patients (38 eyes) undergoing 3.0 mm standard incision Phaco combined with single focus IOLs.The preoperative and postoperative uncorrected visual acuity, corneal curvature, intraocular pressure, corneal endothelium number, and defocus curve were recorded in both groups. The parameters during the operation were also recorded and compared. Results: There was no statistically significant difference in the parameters including total phacoemulsification time, total phacoemulsification energy, phacoemulsification cumulative energy compound parameters, effective phacoemulsification time, average phacoemulsification energy, total surgery time between group A and group B during the operation (all P>0.05). Compared with preoperative, the number of corneal endothelial cells decreased both in the two groups after surgery. The difference was statistically significant (P<0.05). There was no significant difference between the two groups at any time (all P>0.05). There were no complications such as posterior capsule rupture during operation in both groups. The corneal astigmatism was increased after operation both in the 2.2 mm incision and 3.0 mm incision, and the difference was statistically significant compared with pre-operation (both P<0.01). There was no significant difference between the two groups (all P>0.05). At 3 months postoperatively, there was no significant difference in uncorrected distance visual acuity (UCDVA) between the two groups (t=?1.794, P=0.07), and the difference was statistically significant in the uncorrected near visual acuity (UCNVA) (t=?25.147, P<0.01). Defocus curve: The defocus curve of group A had two peaks, which are located near 0 D and ?3.5 D, forming a flat platform with a descent between the two peaks.The defocus curve of group B had only one peak, located at 0–0.5 D, and the downward trend at both ends of the peak was obvious. The rate of off-glasses and satisfaction: the rate of off-glasses in group A was 77.42% (24/31),and the rate of dislocation in group B was 12.90% (4/31). The difference was statistically significant (χ² =26.050,P<0.01). There was no significant difference in overall satisfaction between the two groups (χ2 =1.615, P=0.204).Conclusion: The 2.2 mm coaxial microincision cataract surgery yields high clinical safety, and the combined implantation of multi-focal intraocular lens has good curative effect and can be widely promoted in clinical practice.

Objective: To compare the narcotic effects of chloral hydrate and avertin in mouse models and the success rate of choroidal neovascularization (CNV) mouse model establishment with different energy hierarchy of laser. Methods: Twenty-four mice were randomized into 3 groups, the 532 nm laser was used with different power levels of 200, 300 and 400 mW for each group. In each group, the chloral hydrate was used for 4 mice and avertin for the other 4 mice at random. On day 4, 7, 10 and 14, all mice were tested by the fundus fluorescein angiography (FFA), SD-OCT, and the choroid was stained with the isolectin B4 conjugated AF488 on day 14. Results: The anesthesia induction time of avertin and chloral hydrate was (120±30) s and (150±45) s, and the duration of anesthesia was (30±15) min and (50±20) min, the differences were statistically significant (all P=0.0001); the incidence of irreversible cataract of avertin models and chloral hydrate models was 2/24 and 1/24, the number of death in two models was 1 and without statistical significance (P=0.551, P=0.300). With the increase of laser energy, the success rate of experiments was also gradually increased, from 9.38%, 37.5% to 93.75% (P=0.0001) in 200, 300 and 400 mW group, respectively. According to the results of FFA, the peak of fluorescence leaking was at day 4 after the laser burning, and was gradually reduced. Conclusion: Compared with avertin chloral hydrate can improve the duration of anesthesia without increasing the risk of cataract and mortality. As for the 532 nm laser, the 400 mW energy could be an optimal parameter for the laser-induced CNV.

Objective: To develop and validate a risk prediction model for vision-threatening diabetic retinopathy in patients with type 2 diabetes using readily accessible clinical data, which may provide a convenient and effective prediction tool for early identification and referral of at-risk populations. Methods: A nomogram model was developed using datasets obtained from patients with T2DM who participated in the Guangzhou Diabetic Eye Study during the period of 2017 to 2020. Logistic regression was used to construct the model, and model performance was evaluated using receiver operating characteristic (ROC) curve, Hosmer-Lemeshow test, calibration curve and decision curve analysis (DCA). The model was externally validated in the Dongguan Eye Study. Results: A total of 2161 individuals were included in the model development dataset, of whom 135(6.25%) people were diagnosed with VTDR. Age and body mass index were found to be negatively correlated with VTDR (β<0, P<0.05), whereas diabetes duration, insulin use, systolic blood pressure, glycated hemoglobin, and serum creatinine were positively correlated with VTDR (β>0, P<0.05). All these variables were included in the model as predictors. The model showed strong discrimination in the development dataset with an area under the receiver operating characteristic curve (AUC) of 0.797 and in the external validation dataset (AUC 0.762). The Hosmer-Lemeshow test（P＞0.05）and the calibration curve displayed good agreement. Decision curve analysis showed that the nomogram produced net benefit in two datasets. Conclusions: Age, body mass index, duration of diabetes, insulin use, systolic blood pressure, glycosylated hemoglobin and serum creatinine were found to have significant independent effects on the occurrence of VTDR. The nomogram developed based on these variables demonstrated good predictive validity which could identify those at risk of VTDR in resource-limited settings so that they can be screened and treated early.

?According to statistics, nearly 1.4 billion people are suffering from myopia worldwide, and it has become a major health problem. The cost of myopia correction and associated side effects are a huge burden for both society and individuals. There are few reports on the economic burden of myopia at home and abroad. A large portion of China's population is myopic, it is likely to contribute to the rational allocation of health service resources, the prevention and control of myopia, and the reduction of society's economic burden if an effective study is performed on the economic burden of myopia, which will be reviewed in brief from the concepts of the burden and how it is measured, and the current situation of the burden in countries around the world.

Objective: To compare the accuracy of 10 intraocular lens (IOL) power calculation formulas in eyes undergoing combined silicone oil removal and cataract surgery measured by swept-source optical coherence tomography OA-2000 (Tomey, Japan). Methods: A total of 62 patients (62 eyes) who underwent combined silicone oil removal and cataract surgery at Zhongshan Ophthalmic Center of Sun Yat-sen University from March to July 2021 were enrolled. Preoperative biometry was performed by OA-2000 in all patients. New-generation formulas (Barrett Universal II [BUII], Emmetropia Verifying Optical [EVO] 2.0, Hill-Radial Basis Function [Hill-RBF] 3.0, Hoffer QST, Kane and Pearl-DGS) and traditional formulas (Haigis, Hoffer Q, Holladay 1 and SRK/T) were evaluated. The median absolute prediction error (MedAE) and mean absolute prediction error (MAE) were the main parameters used to assess accuracy. Subgroup analyses were performed according to axial length of 23mm and 26 mm. Results: Six new-generation formulas, Haigis, and SRK/T showed myopic shift (-0.47 diopters [D] ~ -0.27 D, P<0.05), while Hoffer Q and Holladay 1 displayed no systematic bias (P>0.05). The Kane formula showed the smallest MedAE (0.55 D) and MAE (0.81 D), but had no statistically significant difference compared with other formulas (P>0.05). All formulas showed a myopic shift (-1.46 D to -1.25 D, P<0.05) in eyes shorter than 23 mm, while the systematic bias was not significant (-0.32 D to 0.41 D, P>0.05) in other subgroups. In eyes shorter than 23 mm, the Pearl-DGS formula exhibited the smallest MedAE (0.97 D) and MAE (1.26 D), and was significantly more accurate than Hill-RBF 3.0 (P=0.01) and SRK/T (P=0.02). In eyes with an axial length between 23 mm and 26 mm, the Kane formula had the lowest MedAE (0.44 D) and MAE (0.66 D). No significant difference was found in eyes longer than 26 mm. Conclusion: The Kane formula showed the highest accuracy in patients undergoing combined silicone oil removal and cataract surgery measured by OA-2000, whereas the Pearl-DGS formula could be more accurate in eyes with an axial length shorter than 23 mm.

Abstract: Objective: To evaluate the effect of femtosecond laser assisted treatment of high myopia complicated with cataract on macular region by observing visual acuity, retinal thickness, choroid thickness and blood flow density in macular area. Method: Sixty eyes of 50patients with highly myopic cataract undergoing femtosecond laser-assisted phacoemulsification surgery, average age 52±8.47 years old, cataract nucleus：grade II-III , were selected from the cataract surgery Center of Yichang Aier Eye Hospital from 2022.1 to 2023.5. The best corrected visual acuity ，Retinal and choroid thickness in macular area, blood flow density of retina and choroid in macular area were recorded before surgery、 1 week、 1 month、 3 months after surgery . Results: The best corrected visual acuity after surgery was significantly higher than that before surgery (P<0.05). Retinal thickness: There were no significant differences in the central, above and below, nasal and temporal retinal thickness before and after surgery (P>0.05), and there were no significant differences in the central choroid thickness of macula before and after surgery (P>0.05). There was no significant difference in blood flow density of superficial，deep retina and choroid area before and after operation (P>0.05). Conclusion: Femtosecond laser assisted treatment of high myopia complicated cataract is safe and effective, and has no significant effect on macular region.

Objective: To investigate the effect of inhibiting accommodation on ocular refractive development of guinea pigs in different monochromatic lights. Methods: Twenty-four pigmented guinea pigs were randomly divided into three groups with 8 animals per group: short-wavelength light (SL, 430 nm) group, middle-wavelength light (ML,530 nm) group and broad-band light (BL, 5 000 K color temperature) group. The right eyes of all animals were treated by 1% Atropine solution once a day for 6 weeks. Measurements of ocular refraction, corneal curvature, and axial length were performed at the start and the end of the study. Results: There was no significant difference in bilateral ocular refraction for all groups at the beginning of the experiment (about 4.25 D, P>0.05) and in ipsilateral ocular refraction among groups at the start of the experiment (P>0.05). But at the end of the experiment,significant differences were detected between binocular refraction of the ML group (P=0.028) and the SL group (P=0.0003), however, there was no significant difference between bilateral refraction in the BL group (P=0.7486).There were significant differences in refraction between the left eyes of any two groups (P<0.05), between the right eyes of the ML and BL group (P=0.001), and between the right eyes of the ML and SL (P<0.001) at 6 weeks.No significant refractive difference was detected between the right eyes of the SL and BL groups (P=0.072). The vitreous length was about 3.2 mm in bilateral eyes of all groups at the onset of the experiment (all inner- or inter-group P>0.05). After the experiment, the bilateral difference in vitreous length was significant in the ML group(P=0.0113) and the SL group (P=0.0017), but not significant in the BL group (P=0.9371). There were significant vitreous differences in right or left eyes among the groups at the end of the experiment (P<0.01). There were no significant inter-group (ipsilateral) or inner-group (bilateral) differences at any time in any of corneal radius of curvature, anterior segment length and lens thickness (P>0.05 for all comparisons). Conclusion: 1% atropine can strengthen the effect of vitreous elongation and myopic formation on guinea pig eyes in 530 nm monochromatic light. Moreover, atropine can weaken the effect of vitreous shortening and hyperopic formation on guinea pig eyes in 430 nm monochromatic light. Ocular accommodation response should involve in the mechanism of refractive development of guinea pig in monochromatic light. Atropine can influence the refractive development of guinea pig in monochromatic light possibly by inhibiting accommodation response.

Objective: To assess the benefits of intraocular lens (IOL) constant optimization of Alcon Acrysof IQ PanOptix TFNT00 (PanOptix) on the accuracy of IOL power calculation, and the effects of constant optimization between different axial length (AL) groups were further compared. Methods: Patients who underwent phacoemulsification and implantation with PanOptix IOL between June, 2021 and March, 2022 were included in this retrospective study. The preoperative biological ocular parameters, implanted IOL power, and subjective 1-3 month postoperative refraction were collected. Combined with SRK/T, Hoffer Q, Holladay 1 and Haigis formulas, the optimized IOL constant A, surgeon factor (SF), post-surgery anterior chamber depth (pACD), and a0, a1, a2 were back-calculated. Refractive outcomes using optimized IOL constants were re-calculated combined with the corresponding formulas. Compare the mean absolute error (MAE), medium absolute error (MedAE) and percentage of eyes with IOL prediction errors (PE) within ±0.25 diopter (D), ±0.50 D, ±0.75 D and ±1.0 D when using the optimized constants and the manufacture constants. Patients were divided into two groups according to AL (non-high myopia: <26.0mm; high myopia: ≥26mm), compare the difference of IOL constant optimization between AL subgroups. Results: A total of 92 eyes of 54 patients were enrolled. The manufacture lens constant of A, pACD, SF, a0, a1 and a2 are respectively 119.1, 5.63, 1.83, 1.39, 0.4 and 0.1; and the optimized values are respectively 119.35, 6.14, 2.36, -3.42, 0.12 and 0.34. In all patients group, with manufacture lens constant, the MAE values of SRKT, Hoffer Q, Holladay 1 and Haigis formula are 0.44 D, 0.50 D, 0.54 D, 0.46 D; with optimized lens constants, the MAE values are 0.43 D, 0.54 D, 0.51 D, 0.35 D, and there is a statistical difference of Haigis formula after optimization (P=0.001). In non-high myopia group, with manufacture lens constant, the MAE values are 0.46 D, 0.40 D, 0.40 D, 0.42 D; with optimized lens constants, the MAE values are 0.46 D, 0.38 D, 0.39 D, 0.38 D, and no statistical difference has been found. In high myopia group, with manufacture lens constant, the MAE values are 0.42 D, 0.59 D, 0.66 D, 0.50 D; with optimized lens constants, the MAE values are 0.36 D, 0.48 D, 0.47 D, 0.31 D, and there are statistical differences of Holladay 1 and Haigis formula after optimization (P = 0.02，0.002). Conclusions: IOL constant optimization of PanOptix IOL can improve the accuracy of IOL calculation, which is more significant in the high myopia group.

Objective: To observe the efficacy and safety of Phakic Refractive Lens (PRL) implantation for correction of ultra high myopia. Methods: A total of 24 patients (39 eyes) with ultra-high myopia who underwent PRL implantation in Shenzhen Eye Hospital from January 2018 to September 2020 were included for a self-controlled case series study. Of these, 13 eyes were 8 males and 26 eyes were 16 females, with a mean age of (31.15 ± 6.33) years old. Visual acuity (UCVA, BCVA), refraction, intraocular pressure, corneal endothelial cell count, vault, and surgical complications were observed after PRL implantation. PRL preoperative and postoperative refraction, corneal endothelial cell count and postoperative vault, preoperative BCVA and postoperative UCVA were in accordance with the normal distribution, expressed as (x ) ?± s, preoperative and postoperative self-comparison was performed using the paired t-test. Preoperative UCVA and postoperative BCVA, preoperative intraocular pressure were not in accordance with the normal distribution, and the statistical description was expressed as P50 (P25-P75). Wilcoxon signed rank test was used for comparison. Friedman rank test for multiple related samples was used for comparison of intraocular pressure at different time points, and then Wilcoxon signed rank test was used for pairwise comparison. Results: The follow-up time was 5.5 months (3, 11). The preoperative refraction of 34 eyes in 20 patients was (-22.29 ± 4.96) D, and refraction at the last follow-up time after surgery was (-0.28 ± 1.01) D. It was significantly decreased after surgery compared with preoperative (t = 24.421, P = 0.000), of which 28 eyes (82.4%) had spherical power ± 0.5 D and 31 eyes (91.2%) had ± 1.0 D. The preoperative LogMAR UCVA and BCVA were 1.40 (1.30, 1.70) and 0.40 (0.22, 0.70), respectively. UCVA and BCVA at the last follow-up time were 0.28 ± 0.20 and 0.15 (0.00, 0.30), respectively. LogMAR UCVA postoperative was significantly improved compared with UCVA preoperative, and both the UCVA and BCVA postoperative were significantly increased than preoperative BCVA (Z = -5.659, P = 0.000; t = -4.883, P = 0.000; Z = -4.868, P = 0.000). BCVA improved by 3.00 (1.00, 5.00) lines at the last follow-up, and all patients without BCVA loss. The intraocular pressure values among preoperative, at 1 day postoperative and at the last follow up time were15 (14.00, 16.00) mmHg, (18.07 ± 4.04) mmHg and (15.91 ± 3.40) mmHg, respectively. There was significant difference in intraocular pressure values among the three time periods (F = 8.779, P = 0.012).Intraocular pressure was significantly higher at 1 day after surgery than before surgery (Z = -3.401, P = 0.001), but significantly lower at last follow up time than at 1 day after surgery (Z = -2.685, P = 0.007), and there was no significant difference in intraocular pressure before surgery and at the last follow up time(Z = -0.894, P = 0.371).The last follow-up time and preoperative corneal endothelial cell counts were (2472.54 ± 394.32) cells/mm2 and (2782.20 ± 296.30) cells/mm2, respectively, and the endothelial cell counts at the last follow up time was significantly lower than preoperative (t = -5.437, P = 0.000).The mean number of lost corneal endothelial cells was 11.2%.A total of 33 eyes completed the vault measurement at the final follow-up, with a vault range of 15 μm to 1400 μm, and the mean vault was (379.00 ± 283.27) μm, of which 12 eyes (36.4%) were 0 ~ 250 μm, 19 eyes (57.6%) were 250 ~ 750 μm, and 2 eyes (6%) were > 750 μm. The vault measurements within one month and more than three months after PRL surgery in 21 eyes were (373.62±195.75) μm and (269.81±194.67) μm, respectively, which were significantly different (t=-2.917, P=0.009). Postoperative complications included steroid-induced glaucoma (2 eyes in 1 case), PRL optical surface crack (1 eye), macular hemorrhage(1 eye), and PRL decentration (3 eyes in 2 cases). Conclusion: PRL implantation is a safe and effective intraocular refractive surgery for ultra-high myopic patients who do not meet the requirements of ICL implantation. However, its long-term efficacy and safety still need further observation.