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眼视光学杂志（英文版）
眼视光学杂志（英文版）

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眼视光学杂志（英文版）/Journal Eye and VisionCSCDSCI
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    Repeatability and reproducibility of corneal higher-order aberrations measurements after small incision lenticule extraction using the Scheimpflug-Placido topographer

    Rui NingRongrong GaoDavid P.Pi?eroJun Zhang...
    1-9页
    查看更多>>摘要：Background:To evaluate the precision of corneal higher-order aberrations measurements after small incision lentic-ule extraction(SMILE)using the Sirius Scheimpflug-Placido topographer(CSO,Italy).Methods:Seventy-five eyes from 75 postoperative subjects were included in this prospective study.Three con-secutive corneal aberrometric measurements were obtained with the Scheimpflug-Placido topographer by two experienced operators to assess intra-and inter-observer reproducibility.The within-subject standard deviation(Sw),test-retest repeatability(TRT)and the intraclass correlation coefficient(ICC)were calculated.Results:For intraobserver repeatability of anterior and total corneal aberrations,all ICCs were more than 0.922,except for trefoil(0.722 to 0.768).The ICCs of total root mean square(RMS),coma Z(3,±1),and spherical aberration Z(4,0)were over 0.810 while higher-order RMS,trefoil Z(3,±3),and astigmatism ⅡZ(4,±2)were below 0.634 for pos-terior corneal surface aberrations.All Sw values for all types of aberrations were equal to or below 0.07 μm.Regarding interobserver reproducibility,all TRT values were no more than 0.12 μm,0.05 μm,and 0.11 μm for anterior,posterior,and total corneal aberrations,respectively.The ICC values ranged from 0.875 to 0.989,from 0.686 to 0.976 and over 0.834 for anterior,posterior,and total corneal aberrations,respectively.Conclusions:The repeatability of measurements of anterior and total corneal aberrations with the Sirius system in corneas after SMILE surgery was high,except for trefoil.There was some variability in posterior corneal aberrometric measurements.High reproducibility of corneal aberrometric measurements was observed between measurements of both examiners,except for trefoil,with poor to moderate reproducibility.
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    • NSTL
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    PACK-CXL vs.antimicrobial therapy for bacterial,fungal,and mixed infectious keratitis:a prospective randomized phase 3 trial

    Farhad HafeziMohammed HosnyRohit ShettyBoris Knyazer...
    10-20页
    查看更多>>摘要：Background:Infectious keratitis is a major cause of global blindness.We tested whether standalone photoactivated chromophore corneal cross-linking(PACK-CXL)may be an effective first-line treatment in early to moderate infectious keratitis,compared with standard antimicrobial treatment.Methods:This is a randomized,controlled,multinational phase 3 clinical trial.Participants in five centers in Egypt,India,Iran,Israel,and China,aged ≥ 18 years,with infectious keratitis of presumed bacterial,fungal,or mixed origin,were randomly assigned(1∶1)to PACK-CXL,or antimicrobial therapy.Outcomes measures included healing,defined as time to re-epithelialization of the corneal epithelial defect in the absence of inflammatory activity in the anterior chamber and clearance of stromal infiltrates.Treatment success was defined as the complete resolution of signs of infection.Results:Between July 21,2016,and March 4,2020,participants were randomly assigned to receive PACK-CXL(n=18)or antimicrobial therapy per American Academy of Ophthalmology(AAO)guidelines(n=21).No participants were lost to follow-up.Four eyes were excluded from the epithelialization time analysis due to treatment failure:two in the antimicrobial therapy group,and two in the PACK-CXL group.Success rates were 88.9％(16/18 patients)in the PACK-CXL group and 90.5％(19/21 patients)in the medication group.There was no significant difference in time to complete corneal re-epithelialization(P=0.828)between both treatment groups.Conclusions:PACK-CXL may be an alternative to antimicrobial drugs for first-line and standalone treatment of early to moderate infectious keratitis of bacterial or fungal origin.
      原文链接:
    • NETL
    • NSTL
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    jApplication of artificial intelligence in cataract management:current and future directions

    Laura GutierrezJane Sujuan LimLi Lian FooWei Yan Yan Ng...
    21-30页
    查看更多>>摘要：The rise of artificial intelligence(AI)has brought breakthroughs in many areas of medicine.In ophthalmology,Al has delivered robust results in the screening and detection of diabetic retinopathy,age-related macular degenera-tion,glaucoma,and retinopathy of prematurity.Cataract management is another field that can benefit from greater Al application.Cataract is the leading cause of reversible visual impairment with a rising global clinical burden.Improved diagnosis,monitoring,and surgical management are necessary to address this challenge.In addition,patients in large developing countries often suffer from limited access to tertiary care,a problem further exacerbated by the ongoing COVID-19 pandemic.Al on the other hand,can help transform cataract management by improving automation,efficacy and overcoming geographical barriers.First,Al can be applied as a telediagnostic platform to screen and diagnose patients with cataract using slit-lamp and fundus photographs.This utilizes a deep-learning,convolutional neural network(CNN)to detect and classify referable cataracts appropriately.Second,some of the latest intraocular lens formulas have used Al to enhance prediction accuracy,achieving superior postoperative refractive results compared to traditional formulas.Third,Al can be used to augment cataract surgical skill training by identifying different phases of cataract surgery on video and to optimize operating theater workflows by accurately predicting the duration of surgical procedures.Fourth,some Al CNN models are able to effectively predict the progression of posterior capsule opacification and eventual need for yttrium aluminum garnet(YAG)laser capsulotomy.These advances in Al could transform cataract management and enable delivery of efficient ophthalmic services.The key challenges include ethical management of data,ensuring data security and privacy,demonstrating clinically acceptable performance,improving the generalizability of Al models across heterogeneous populations,and improving the trust of end-users.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Patients' dissatisfaction with multifocal intraocular lenses managed by exchange with other multifocal lenses of different optical profiles

    Olena Al-ShymaliColm McAlindenJorge L.Alio del BarrioMario Canto-Cerdan...
    31-40页
    查看更多>>摘要：Background:The aim of the study was to evaluate the outcomes of dissatisfied patients reporting poor visual quality following implantation of multifocal intraocular lenses(MF-IOLs),managed by IOL exchange with another multifocal optical profile.Methods:This is a retrospective series of cases.MF-IOL exchange was done in 15 dissatisfied patients(30 eyes)with the perception of poor visual quality for far distance affected by neuroadaptation failure.Patients underwent a bilateral exchange of a MF-IOL with another MF-IOL of a different optical profile.Visual outcomes and complications were analyzed.Questionnaires including Quality of Vision(QoV),Visual Function Index-14(VF-14)and its Rasch-revised version(VF-8R)and a satisfaction questionnaire were also used for outcome evaluation.Results:The mean elapsed time from implantation to explantation-reimplantation was 11.8 months.The QoV scores improved significantly across all the three subscales.Visual function improved with a change in VF-14 score from 60.41±24.81 to 90.16±10.91(P＜0.001).The VF-8R score improved as well.The uncorrected distance visual acuity improved from 0.24 to 0.12 logMAR after exchange(P＜0.001)and corrected distance visual acuity improved from 0.15 to 0.04 logMAR(P＜0.001).Safety and efficacy indexes reached 1.46 and 1.16,respectively.Concerning patients'satisfaction following MF-IOL exchange,80％of the patients reported they would have the MF-IOL reimplantation procedure again.Conclusions:Patient dissatisfaction with neuroadaptation failure following MF-IOL implantation can be managed in 80％of our cases by MF-IOL exchange with a different MF-IOL optical profile.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

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      原文链接:
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    • NSTL
    • 万方数据