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Rahimi M, Panahi Bazaz M, Sharifipour F, Hajizadeh M, Cheraghian B. Corneal biomechanical changes after Descemet stripping automated endothelial keratoplasty, penetrating keratoplasty, and phacoemulsification. Int Ophthalmol 2022; 42:3183-3190. [PMID: 35552955 DOI: 10.1007/s10792-022-02318-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/18/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate corneal biomechanical changes after Descemet stripping automated endothelial keratoplasty (DSAEK), penetrating keratoplasty (PK), and phacoemulsification (PE). METHODS This prospective study included 138 eyes which underwent PK (26 eyes), DSAEK (26 eyes), PE (57 eyes), and 29 normal eyes. Intraocular pressure (IOP) was measured by Goldmann applanation tonometer (GAT), and central corneal thickness (CCT) and axial length by ultrasound. The ocular response analyzer was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-related IOP (IOPg), and cornea-compensated IOP (IOPcc) preoperatively and 1, 3, and 6 months postoperatively. RESULTS At baseline, PK group had the lowest CH and CRF. There was a significant increase in CH and CRF to normal values in PK (P = 0.015 and 0.006) and PE (P = 0.005 and 0.0001) groups over the study period. At 6 months, CH and CRF increased and reached normal values in the PK group; increased to a lower level than normal in the DSAEK group; and, after an initial reduction, increased to normal values in the PE group. At 6 months, DSAEK group had the lowest CH and CRF. There was a significant positive correlation between CRF and GAT (r = 0.281, P = 0.009), IOPg and GAT (r = 0.335, P = 0.001), and IOPcc and GAT (r = 0.282, P = 0.001). CH was negatively correlated with age (r = - 0.189, P = 0.04). CONCLUSION Corneal biomechanical factors increase after DSAEK and PK. At post-operative month six, they reach normal values in PK group, but are lower than normal in DSAEK group.
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Affiliation(s)
- Mahnaz Rahimi
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Farideh Sharifipour
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science and Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science and Department of Ophthalmology, Labbafinejad Medical Center, Boostan 9th st., Pasdaran Ave, Tehran, 1666663111, Iran.
| | - Maryam Hajizadeh
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Meduri A, Oliverio G, Severo AA, Camellin U, Rechichi M, Aragona P. Double safe suture during cataract surgery on post radial keratotomy patients using clear corneal incisions. Eur J Ophthalmol 2022; 32:1828-1832. [PMID: 35229692 DOI: 10.1177/11206721221083799] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE the aim of this study is to find a safer surgical approach in cataract surgery on eyes previously treated with radial keratotomy using clear corneal incisions. SETTING Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy. DESIGN Prospective study. METHODS A prospective study was conducted on a group of 20 patients, 21 eyes with 16 RK incisions were evaluated for cataract phacoemulsification. Samples were divided into two groups: Group 1 underwent surgery with pre-operative one corneal stitch along radial keratotomy incisions near the main access site whereas Group 2 underwent modified surgery with two corneal stitches. RESULTS After surgery, visual acuity, corneal hysteresis and corneal strength was evaluated. In all cases, an increased visual acuity was observed. Group 1 showed an UCVA of logMAR 0.22 ± 0.14, while group 2 presented a logMAR of 0.1 ± 0.07. Data did not show a statistically significant difference in UCVA after surgery between the two groups (P = 0.133). Instead, a significant difference in corneal hysteresis (CH), respectively with values of 8.65 ± 1.6 mmHg in group 1 and 9.2 ± 1.8 in group 2 (P = 0.031), and a corneal resistance factor (CRF) with values of 7.87 ± 1.4 mmHg in the first group and 8.65 ± 1.6 mmHg in the second one (P = 0.039) was observed. CONCLUSIONS Double safe suture technique offers better stabilization of corneal structure during surgery in patients preventively treated with 16 incisions RK.
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Affiliation(s)
- Alessandro Meduri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, 18980University of Messina, Messina, Italy
| | - Giovanni Oliverio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, 18980University of Messina, Messina, Italy
| | - Alice Antonella Severo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, 18980University of Messina, Messina, Italy
| | - Umberto Camellin
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, 18980University of Messina, Messina, Italy
| | | | - Pasquale Aragona
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Regional Referral Center for the Ocular Surface Diseases, 18980University of Messina, Messina, Italy
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Noninvasive Machine Learning Screening Model for Dacryocystitis Based on Ocular Surface Indicators. J Craniofac Surg 2021; 33:e23-e28. [PMID: 34267140 DOI: 10.1097/scs.0000000000007863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Dacryocystitis is an orbital disease that can be easily misdiagnosed. The most common diagnostic tools for dacryocystitis are computed tomography, lacrimal duct angiography, and lacrimal tract irrigation. Yet, those are invasive methods, which are not conducive to extensive screening. OBJECTIVE To explore the significance of ocular surface indicators and demographic data in the screening of dacryocystitis. MATERIALS AND METHODS Data were prospectively collected from 56 patients with dacryocystitis (56 eyes) and 56 healthy individuals. Collected indicators included demographic information (gender, age), ocular surface data of tear meniscus height, objective scatter index (OSI), and clinical diagnosis. The model features were screened out by machine learning to establish a dacryocystitis screening model. RESULTS Tear meniscus height, OSI_maximum Lyapunov exponent, basic OSI, median of OSI, mean of OSI, slope coefficient of OSI linear regression, coefficient of variation in OSI, interquartile range of OSI, and other 8 parameters were used as model parameters to establish a dacryocystitis screening model with an overall detection accuracy of 85.71%. CONCLUSIONS This new screening model that is based on ocular surface indicators provides a new option for noninvasive screening of dacryocystitis.
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Effect of trabeculectomy and Ahmed glaucoma valve implantation surgery on corneal biomechanical changes. Int Ophthalmol 2020; 40:1941-1947. [PMID: 32300919 DOI: 10.1007/s10792-020-01367-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/03/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate alterations in corneal biomechanical properties before and 6 months after conventional trabeculectomy (TRAB) and Ahmed glaucoma valve (AGV) implantation. METHODS Thirty-nine eyes of 39 patients were evaluated retrospectively. Complete ophthalmological examinations including evaluation of corneal biomechanical properties using the Ocular Response Analyzer were performed before and after 6 months postoperatively. A mean of four measurements for corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann correlated intraocular pressure (IOPg), and corneal compensated intraocular pressure (IOPcc) was recorded. The participants had undergone trabeculectomy or shunt surgery as the first surgical procedure for glaucoma treatment of uncontrolled IOP with maximum antiglaucoma eyedrops. RESULTS There were 20 eyes of 20 patients in trabeculectomy group and 19 eyes of 19 patients in AGV implantation group. There was no significant difference between two groups in terms of sex, age, eye laterality, lens status, antiglaucoma drug usage, preoperatively measured Mean Deviation of Humphrey Visual Field Analyzer, CH, CRF, IOPcc, and IOPg (p > 0.05). CH and CRF increased significantly after shunt surgery (p < 0.001). CH increased in trabeculectomy group postoperatively (p < 0.001); however, CRF showed a small amount of decrease, but this reduction was not statistically significant (p > 0.05). CH and CRF showed higher increase after AGV surgery than trabeculectomy surgery (p < 0.05). There was no significant correlation between IOP changes and CH-CRF changes in both TRAB and AGV groups (p > 0.05). CONCLUSION According to our results, surgical technique differences may have an impact on postoperative corneal biomechanical outcomes. AGV surgery offers better corneal biomechanical results than standard trabeculectomy in 6-month follow-up.
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Corneal Biomechanical Changes After Uneventful Phacoemulsification in Patients With Type 2 Diabetes Mellitus and Patients Without Diabetes. Cornea 2020; 39:1073-1079. [PMID: 32301813 DOI: 10.1097/ico.0000000000002332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare corneal biomechanical changes after uneventful phacoemulsification cataract surgery between type 2 diabetic (DM) and nondiabetic patients. METHODS Forty-four diabetic (44 eyes) and 44 (44 eyes) age and sex-matched non-DM controls with age-related cataract were enrolled in this prospective observational study. Corneal hysteresis (CH), corneal resistance factor (CRF), and corneal-compensated intraocular pressure (IOPcc) were evaluated by using the ocular response analyzer; central corneal thickness was recorded by using the Pentacam HR. Patients were evaluated preoperatively and 1 and 6 months after surgery. RESULTS In the DM group, CH was observed to be significantly lower than preoperative value (9.8 ± 1.5 mm Hg) at 1 month (9.4 ± 1.2 mm Hg, P = 0.040), but not at the 6-month follow-up (9.6 ± 1.6 mm Hg, P = 0.437),whereas it did not change significantly in the non-DM group (preoperative 9.8 ± 1.3 mm Hg vs. 1 month 9.6 ± 1.1 mm Hg vs. 6 months 10.1 ± 1.1 mm Hg, P > 0.05). CRF was significantly lower than the preoperative values at 1 and 6 months in both groups (P ≤ 0.001). Postoperative CH change was significantly associated with preoperative CH (P < 0.001), preoperative IOPcc (P = 0.004), and IOPcc change (P < 0.001), whereas CRF change was only correlated with preoperative CRF (P < 0.001). There was a significant postoperative IOPcc reduction 6 months after surgery (P < 0.001) in both DM and non-DM groups; however, central corneal thickness was not found to significantly change in the postoperative period (P > 0.05). CONCLUSIONS This study showed that phacoemulsification causes a significant and persistent decrease in intraocular pressure and CRF in both groups, whereas CH recovered to preoperative values, although more slowly in patients with diabetes.
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Frisina R, De Biasi CS, Londei D, Gambato C, Midena E. A new intraocular lens with artificial iris for treating a case of iris extrusion secondary to traumatic opening of a radial keratotomy. Eur J Ophthalmol 2020; 31:NP5-NP10. [PMID: 31973591 DOI: 10.1177/1120672120902035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Traumatic globe rupture can lead to aniridia with subsequent glare, light sensitivity and psychological discomfort. The authors report the results of a sulcus implantation of a new intraocular lens with artificial iris (Reper) in an eye affected by traumatic opening of a radial keratotomy incision with total iris extrusion and subluxated cataract. METHODS A case of 56-year-old female affected by aniridia and subluxated cataract in left eye secondary to a traumatic opening of one of 12 radial keratotomy underwent a Reper implantation with three-point transcleral fixation. The following parameters were collected at 1, 3 and 6 postoperative months: best-corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness (CCT), simulated keratometry (Sim K), endothelial cell count (ECC) and anterior chamber depth (ACD). Pupil spread function study was performed to evaluate the high-order aberrations and the quality of vision. RESULTS BCVA improved from light perception to 20/20 (Snellen fraction) at 6 postoperative months. No IOP postoperative peaks were detected. CCT was 520 μm at 6 postoperative months. Corneal topography showed regularization with symmetrical flattening of the central part and a residual peripheral curvature. No significant reduction of ECC was detected. ACD was stable, superior to 3 mm at each time point of follow-up. Pupil spread function study highlighted that the quality of vision was the same in both eyes at the end of follow-up. CONCLUSION Reper is a promising functional and cosmetic solution for the treatment of aphakia and aniridia.
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Affiliation(s)
- Rino Frisina
- Department of ophthalmology, University of Padova, Padova, Italy
| | | | - Davide Londei
- Department of ophthalmology, University of Padova, Padova, Italy
| | - Catia Gambato
- Department of ophthalmology, University of Padova, Padova, Italy
| | - Edoardo Midena
- Department of ophthalmology, University of Padova, Padova, Italy
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Sorkhabi R, Najafzadeh F, Sadeghi A, Ahoor M, Mahdavifard A. Corneal biomechanical changes after trabeculectomy with mitomycin C in primary open-angle glaucoma and pseudoexfoliation glaucoma. Int Ophthalmol 2019; 39:2741-2748. [PMID: 31134423 DOI: 10.1007/s10792-019-01118-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/22/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to examine the effect of trabeculectomy with mitomycin C on corneal biomechanical characteristics in PEXG and POAG patients. METHODS In this prospective comparative case series study, 32 glaucoma patients of whom 17 patients were suffering from PEXG and 15 patients from POAG were enrolled. All patients underwent complete ocular examination, CCT using ultrasound pachymetry and corneal biomechanical study using ORA. The patients were hospitalized, and trabeculectomy surgery with mitomycin was done. Three months after surgery, patients were examined and ORA was obtained again. RESULTS The mean CH in patients with PEXG was lower compared to patients with POAG (5.66 ± 1.13, 7.49 ± 0.88, respectively) before surgery, which had a statistically significant difference (P < 0.001). CRF in patients with PEXG was significantly lower compared to patients with POAG (8.19 ± 1.48 vs. 9.35 ± 1.60, respectively) before surgery, with P = 0.049. CH remarkably increased and reached 6.69 ± 0.78 (P < 0.001) in the PEXG group after TBX + MMC surgery. CH increased in the POAG group after TBX + MIC surgery and reached 8.23 ± 1.09, which was statistically significant (P = 0.001). There was a significant relationship between CH and IOPg changes in both PEXG and POAG groups (P < 0.001 and P = 0.01, respectively). Although TBX + MMC surgery changed the amount of CH in PEXG and POAG groups, no significant difference was shown in the parameters between the two groups comparing the CH changes (P = 0.33). CONCLUSION According to the results of this study, the biomechanical characteristics of cornea, particularly CH, shows certain changes following surgery and is increased, reflecting the dynamic nature of these parameters. Our knowledge of the biomechanical changes after glaucoma surgery can help us better understand the pathophysiology of glaucoma diseases and make the right decisions for follow-up of the patients.
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Affiliation(s)
- Rana Sorkhabi
- Nikookari Hospital (Eye Center), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Najafzadeh
- Nikookari Hospital (Eye Center), Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Ali Sadeghi
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamadhosein Ahoor
- Nikookari Hospital (Eye Center), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Mahdavifard
- Nikookari Hospital (Eye Center), Tabriz University of Medical Sciences, Tabriz, Iran
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Age-Related Variations of Rabbit Corneal Geometrical and Clinical Biomechanical Parameters. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3684971. [PMID: 29104870 PMCID: PMC5574220 DOI: 10.1155/2017/3684971] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/23/2017] [Accepted: 06/27/2017] [Indexed: 11/30/2022]
Abstract
Purpose To study the variations in corneal clinical biomechanical parameters (CCBP) and corneal geometrical parameters of rabbit in relation to age. Methods Rabbits aged 3, 7, 12, 18, and 24 months were enrolled. Each eye of the rabbits was tested with Ocular Response Analyzer (ORA), Optical Coherence Tomography (OCT), and Pachymeter to obtain the intraocular pressure (IOP): Goldmann-correlated IOP (IOPg) and Corneal Compensated Intraocular Pressure (IOPcc); CCBP: Corneal Hysteresis (CH) and Corneal Resistance Factor (CRF); corneal geometric parameters: corneal curvature radius (CCR) and central corneal thickness (CCT). Results The IOP of the rabbits changes slightly from 3 to 7 months of age, while it significantly decreases from 7 to 18 months of age and increases from 18 to 24 months of age; CH and CRF decrease with the increase of age; CCT increases from 7 to 18 months and decreases from 3 to 7 months of age and from 18 to 24 months of age; CCR presents an upward trend from 3 to 18 months and a significant decrease between 18 and 24 months of age. Conclusion CH and CRF are negatively correlated with age. CCT and CCR are positively correlated with age.
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Bao F, Savini G, Shu B, Zhu S, Gao R, Dang G, Yu A, Wang Q, Huang J. Repeatability, Reproducibility, and Agreement of Two Scheimpflug-Placido Anterior Corneal Analyzers for Posterior Corneal Surface Measurement. J Refract Surg 2017; 33:524-530. [DOI: 10.3928/1081597x-20170606-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 05/16/2017] [Indexed: 11/20/2022]
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Meduri A, Urso M, Signorino GA, Rechichi M, Mazzotta C, Kaufman S. Cataract surgery on post radial keratotomy patients. Int J Ophthalmol 2017; 10:1168-1170. [PMID: 28730124 DOI: 10.18240/ijo.2017.07.23] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 12/29/2016] [Indexed: 11/23/2022] Open
Abstract
This study aims to evaluate and to compare three different approaches of cataract surgery to patients with previous radial keratotomy (RK), and to analyze the mechanical properties of the cornea after cataract surgery. Three groups of patients, each one including 8 eyes of patients with 16 RK incisions. The first group includes eyes with the first cataract incision superiorly, the second group in the temporal area, the third group in temporal area and a precautionary stabilizing suture across the RK incision adjacent to the main tunnel. In the first group intraoperative dehiscence occurred in three eyes (37.5%): it required immediate application of a suture. In the second group dehiscence occurred intraoperatively in two radial scars (20%): it required immediate application of a suture. In the third group, no intraoperative dehiscences were observed. The stabilizing suture of the RK incision works safer, with a lower risk of dehiscences and less post-operative astigmatism.
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Affiliation(s)
- Alessandro Meduri
- Department of Surgical Specialties, Ophthalmology Clinic, University of Messina, Messina 98100, Italy
| | - Mario Urso
- Department of Surgical Specialties, Ophthalmology Clinic, University of Messina, Messina 98100, Italy
| | - Giuseppe A Signorino
- Department of Surgical Specialties, Ophthalmology Clinic, University of Messina, Messina 98100, Italy
| | - Miguel Rechichi
- Department of Ophthalmology, University Magna Graecia, Catanzaro 88100, Italy
| | - Cosimo Mazzotta
- Mazzotta Cross-Linking & Refractive Surgery Center, Siena 53100, Italy
| | - Stephen Kaufman
- Department of Ophthalmology, State University of New York-Downstate, Brooklyn and Manhattan, New York 11203, United States
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Wei Y, Xu L, Song H. Application of Corvis ST to evaluate the effect of femtosecond laser-assisted cataract surgery on corneal biomechanics. Exp Ther Med 2017; 14:1626-1632. [PMID: 28781631 PMCID: PMC5526192 DOI: 10.3892/etm.2017.4675] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/08/2017] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to evaluate the effects of femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification on corneal biomechanics using corneal visualization Scheimpflug technology. The medical records of 50 eyes from 50 patients who received phacoemulsification and intraocular lens implantation because of age-related factors between June 2014 and September 2014 were retrospectively analyzed. FLACS was used in 12 eyes (FLACS group), and conventional phacoemulsification in 38 eyes (PHACO group). The evaluation of corneal biomechanical parameters included the first/second applanation time (A-time1/A-time2), the first/second applanation length (A-length1/A-length2), corneal velocity during the first/second applanation moment (Vin/Vout), highest concavity time, highest concavity-radius (HC-radius), peak distance (PD), deformation amplitude (DA), central corneal thickness (CCT), and intraocular pressure (IOP). The differences in A-length1/A-length2, IOP, CCT, PD, and DA were significant in the PHACO group between those before, 1 week after, and 1 month after surgery. No significant differences in corneal biomechanical parameters were found between those at 1 month after surgery and before surgery. There were significant differences in IOP and CCT in the FLACS group between those before, 1 week after, and 1 month after surgery. There were no significant differences in the other corneal biomechanical parameters. No significant differences were found in corneal biomechanical parameters between those 1 month after surgery and before surgery. There were significant differences in A-length1/A-length2, CCT, PD, and DA between the two groups at 1 week after surgery. There were no significant differences in corneal biomechanical parameters between the two groups at 1 month after surgery. In conclusion, the effect of FLACS on corneal biomechanics is smaller than that of phacoemulsification. The corneal biomechanical parameters are restored to preoperative levels with the healing of the incision, and the reduction of swelling of the tissue near the incision.
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Affiliation(s)
- Yinjuan Wei
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, P.R. China
| | - Lingxiao Xu
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, P.R. China
| | - Hui Song
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, P.R. China
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