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Kaiser KP, Bucur J, Jandewerth T, Kohnen T, Lwowski C. Fellow eye data for intraocular lens calculation in eyes undergoing combined phacovitrectomy. Acta Ophthalmol 2024. [PMID: 38994803 DOI: 10.1111/aos.16741] [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: 05/07/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
PURPOSE To evaluate whether the intraocular lens (IOL) calculation of the fellow eye (FE) can be used in eyes undergoing combined phacovitrectomy. METHODS In this retrospective, consecutive case series, we enrolled patients who underwent combined phacovitrectomy with silicone oil removal and IOL implantation at the Goethe-University. Preoperative examinations included biometry (IOLMaster 700; Carl Zeiss). We used the IOL calculation of the FE (FE group) to calculate the prediction error compared with the IOL calculation using only the axial length (AL) of the FE (AL-FE group), as well as using the AL of the operated eye (OE group) in addition to the measurable biometric parameters. IOL calculation was performed using the Barrett Universal II formula. We compared the mean (MAE) and median absolute prediction error (MedAE) with each other. Furthermore, the number of eyes with ±0.50, ±1.00 and ±2.00 dioptres (D) deviation from the target refraction was compared. RESULTS In total, 79 eyes of 79 patients were included. MedAE was lowest in the OE group (0.41 D), followed by FE group (1.00 D) and AL-FE group (1.02 D). Comparison between the AL-FE and FE groups showed no statistically significant difference (p = 0.712). Comparing eyes within ±0.50 D of the target refraction, the OE group (63.3%) performed best, followed by the AL-FE group (27.8%) and the FE group (26.6%). CONCLUSION Our results indicate no clinically relevant difference between using the IOL calculation of the FE versus using only the AL of the FE in addition to the measurable parameters for the IOL calculation. A two-step procedure should always be strived for.
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Affiliation(s)
| | - Julian Bucur
- Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany
| | - Tyll Jandewerth
- Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany
| | - Thomas Kohnen
- Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany
| | - Christoph Lwowski
- Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany
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Lwowski C, Kaiser KP, Bucur J, Schicho P, Kohnen T. Accuracy of using the axial length of the fellow eye for IOL calculation in retinal detachment eyes undergoing silicone oil removal. Br J Ophthalmol 2024; 108:921-926. [PMID: 37845000 DOI: 10.1136/bjo-2023-323581] [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: 03/13/2023] [Accepted: 09/20/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE Evaluate whether the axial length of the fellow eye can be used to calculate the intraocular lens (IOL) in eyes with retinal detachment. DESIGN Retrospective, consecutive case series. METHODS Our study was conducted at the Goethe University and included patients who underwent silicone oil (SO) removal combined with phacoemulsification and IOL implantation. Preoperative examinations included biometry (IOLMaster 700, Carl Zeiss). We measured axial length (AL) of operated eye (OE) or fellow eye (FE) and compared mean prediction error and mean and median absolute prediction error (MedAE) using four formulas and AL of the OE (Barrett Universal II (BUII)-OE). Additionally, we compared the number of eyes within ±0.50, ±1.00 and ±2.00 dioptre (D) from target refraction. RESULTS In total, 77 eyes of 77 patients met our inclusion criteria. MedAE was lowest for the BUII-OE (0.42 D) compared with Kane-FE (1.08 D), BUII-FE (1.02 D) and Radial Basis Function 3.0 (RBF3.0)-FE (1.03 D). This was highly significant (p<0.001). The same accounts for the number of eyes within ±0.50 D of the target refraction with the BUII-OE (44 eyes, 57%) outperforming the RBF3.0-FE (20 eyes, 25.9%), Kane-FE and BUII-FE formula (21 eyes, 27.2%) each. CONCLUSION Our results show a statistically and clinically highly relevant reduction of IOL power predictability when using the AL of the FE for IOL calculation. Using the AL of the SO filled eye after initial vitrectomy results in significantly better postoperative refractive results. A two-step procedure using the AL of the OE after reattachment of the retina is highly recommended.
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Affiliation(s)
| | | | - Julian Bucur
- Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | - Philipp Schicho
- Institute for Theoretical Physics, Goethe University, Frankfurt, Germany
| | - Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Frankfurt, Germany
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Hartmann A, Grabitz SD, Wagner FM, Wild PS, Müller-Nurasyid M, Lackner KJ, Beutel ME, Münzel T, Tüscher O, Schattenberg JM, Pfeiffer N, Schuster AKG. Bi-Gaussian analysis reveals distinct education-related alterations in spherical equivalent and axial length-results from the Gutenberg Health Study. Graefes Arch Clin Exp Ophthalmol 2024; 262:1819-1828. [PMID: 38446204 PMCID: PMC11106185 DOI: 10.1007/s00417-024-06395-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/26/2023] [Accepted: 01/31/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE The aim of this study is to investigate the distribution of spherical equivalent and axial length in the general population and to analyze the influence of education on spherical equivalent with a focus on ocular biometric parameters. METHODS The Gutenberg Health Study is a population-based cohort study in Mainz, Germany. Participants underwent comprehensive ophthalmologic examinations as part of the 5-year follow-up examination in 2012-2017 including genotyping. The spherical equivalent and axial length distributions were modeled with gaussian mixture models. Regression analysis (on person-individual level) was performed to analyze associations between biometric parameters and educational factors. Mendelian randomization analysis explored the causal effect between spherical equivalent, axial length, and education. Additionally, effect mediation analysis examined the link between spherical equivalent and education. RESULTS A total of 8532 study participants were included (median age: 57 years, 49% female). The distribution of spherical equivalent and axial length follows a bi-Gaussian function, partially explained by the length of education (i.e., < 11 years education vs. 11-20 years). Mendelian randomization indicated an effect of education on refractive error using a genetic risk score of education as an instrument variable (- 0.35 diopters per SD increase in the instrument, 95% CI, - 0.64-0.05, p = 0.02) and an effect of education on axial length (0.63 mm per SD increase in the instrument, 95% CI, 0.22-1.04, p = 0.003). Spherical equivalent, axial length and anterior chamber depth were associated with length of education in regression analyses. Mediation analysis revealed that the association between spherical equivalent and education is mainly driven (70%) by alteration in axial length. CONCLUSIONS The distribution of axial length and spherical equivalent is represented by subgroups of the population (bi-Gaussian). This distribution can be partially explained by length of education. The impact of education on spherical equivalent is mainly driven by alteration in axial length.
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Affiliation(s)
- Alica Hartmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Stephanie Desirée Grabitz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Felix Mathias Wagner
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp Sebastian Wild
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | | | - Karl Johannes Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred Elmar Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Institute of Molecular Biology (IMB), Mainz, Germany
- Clinic for Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Jörn Markus Schattenberg
- Metabolic Liver Research Center, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Zhong Y, Yang Y, Zhang L, Ma D, Wen K, Cai J, Cai Z, Wang C, Chai X, Zhong J, Liang B, Huang Y, Xian H, Li Z, Yang X, Chen D, Zhang G, Huang Z. Revealing new insights: Two-center evidence of microplastics in human vitreous humor and their implications for ocular health. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 921:171109. [PMID: 38387563 DOI: 10.1016/j.scitotenv.2024.171109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/07/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024]
Abstract
Microplastics (MPs), an emerging environmental contaminant, have raised growing health apprehension due to their detection in various human biospecimens. Despite extensive research into their prevalence in the environment and the human body, the ramifications of their existence within the enclosed confines of the human eye remain largely unexplored. Herein, we assembled a cohort of 49 patients with four ocular diseases (macular hole, macular epiretinal membrane, retinopathy and rhegmatogenous retinal detachment) from two medical centers. After processing the samples with an optimized method, we utilized Laser Direct Infrared (LD-IR) spectroscopy and Pyrolysis Gas Chromatography/Mass Spectrometry (Py-GC/MS) to analyze 49 vitreous samples, evaluating the characteristics of MPs within the internal environment of the human eye. Our results showed that LD-IR scanned a total of 8543 particles in the composite sample from 49 individual vitreous humor samples, identifying 1745 as plastic particles, predominantly below 50 μm. Concurrently, Py-GC/MS analysis of the 49 individual samples corroborated these findings, with nylon 66 exhibiting the highest content, followed by polyvinyl chloride, and detection of polystyrene. Notably, correlations were observed between MP levels and key ocular health parameters, particularly intraocular pressure and the presence of aqueous humor opacities. Intriguingly, individuals afflicted with retinopathy demonstrated heightened ocular health risks associated with MPs. In summary, this research provides significant insights into infiltration of MP pollutants within the human eye, shedding light on their potential implications for ocular health and advocating for further exploration of this emerging health risk.
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Affiliation(s)
- Yizhou Zhong
- Translational Medicine Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China; NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yuhang Yang
- Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, China
| | - Linan Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, China
| | - Dahui Ma
- Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, China
| | - Kailiang Wen
- Meizhou city Meijiang district Shenmei Eye Hospital, Meizhou 514031, China
| | - Jiachun Cai
- Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, China
| | - Zhanmou Cai
- Meizhou city Meijiang district Shenmei Eye Hospital, Meizhou 514031, China
| | - Cui Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, China
| | - Xiaoyan Chai
- Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, China
| | - Jingwen Zhong
- Meizhou city Meijiang district Shenmei Eye Hospital, Meizhou 514031, China
| | - Boxuan Liang
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yuji Huang
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Hongyi Xian
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Zhiming Li
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Xingfen Yang
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Da Chen
- College of Environment and Climate, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Guoming Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, China.
| | - Zhenlie Huang
- NMPA Key Laboratory for Safety Evaluation of Cosmetics, Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Toxicology, School of Public Health, Southern Medical University, Guangzhou 510515, China.
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Fan W, Zhang C, Ge L, Su N, Chen J, Song S, Wang Y, Yuan S. Prediction model for elevated intraocular pressure risk after silicone oil filling based on clinical features. Front Med (Lausanne) 2024; 10:1340198. [PMID: 38264037 PMCID: PMC10803451 DOI: 10.3389/fmed.2023.1340198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024] Open
Abstract
Background To evaluate risk factors and further develop prediction models for intraocular pressure elevation (IOP) after vitreoretinal surgery with silicone oil tamponade to support clinical management. Methods A retrospective study analyzed 1,061 eyes of 1,061 consecutive patients that presented to the Jiangsu Province Hospital between December 2015 and December 2020, the IOP was measured from the preoperative visit and at the 1-week, 1-month, 3-month, and 6-month visits, and the final postoperative visit before silicone oil removal. Four machine learning methods were used to carried out the prediction of IOP elevation: Decision Tree, Logistic Regression, Random Forest, and Gradient-Boosted Decision Trees (GBDT) based on features including demographic and clinical characteristics, preoperative factors and surgical factors. Predictors were selected based on the p-value of the univariate analysis. Results Elevated intraocular pressure developed in 26.01% of the eyes postoperatively. Elevated intraocular pressure primarily occurred within 1-2 weeks after surgery. Additionally, the majority of IOP values were distributed around 25-40 mmHg. GBDT utilizing features with p-values less than 0.5 from the hypothesis testing demonstrated the best predictive performance for 0.7944 in accuracy. The analysis revealed that age, sex, hypertension, diabetes, myopia, retinal detachment, lens status and biological parameters have predictive value. Conclusion Age, sex, hypertension, diabetes, myopia, retinal detachment, lens status and biological parameters have influence on postoperative intraocular pressure elevation for patients with silicone oil tamponade after pars plana vitrectomy. The prediction model showed promising accuracy for the occurrence of IOP elevation. This may have some reference significance for reducing the incidence of high intraocular pressure after pars plana vitrectomy combined with silicone oil filling.
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Affiliation(s)
- Wen Fan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chaohe Zhang
- Key Laboratory of High Confidence Software Technologies, Ministry of Education, Peking University, Beijing, China
- School of Computer Science, Peking University, Beijing, China
| | - Lexin Ge
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Na Su
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiaqin Chen
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Siyao Song
- School of Computer Science, Peking University, Beijing, China
- National Engineering Research Center of Software Engineering, Peking University, Beijing, China
- Software College, Northeastern University, Shenyang, China
| | - Yasha Wang
- Key Laboratory of High Confidence Software Technologies, Ministry of Education, Peking University, Beijing, China
- National Engineering Research Center of Software Engineering, Peking University, Beijing, China
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Munyapa T, Mzumara T, Ogbonna G, Mvula A. Analysis of Goldman Applanation Tonometry with and without fluorescein among glaucomatous and nonglaucomatous patients attending Mzuzu Central Hospital in Malawi: A cross-sectional study. Health Sci Rep 2023; 6:e1390. [PMID: 37404454 PMCID: PMC10314974 DOI: 10.1002/hsr2.1390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/06/2023] Open
Abstract
Background and Aim Goldman Applanation Tonometry (GAT), the gold standard of tonometry, is used without fluorescein in low-resource settings. Nevertheless, corneal biomechanics differ among population groups. Purpose The aim of the study is to assess the relationship between GAT findings with and without fluorescein among glaucomatous and nonglaucomatous adults in Malawi. Methods This was a cross-sectional quantitative study involving 22 glaucoma patients and 22 nonglaucoma patients at Mzuzu Central Hospital. We used a purposive sampling technique to select participants into the two groups. Next, we measured intraocular pressure using GAT with and without fluorescein. Then we entered the data into SPSS version 25. We employed the Wilcoxon test to make comparisons based on age and gender. We considered the value of p < 0.05 statistically significant. Results There is a statistically significant and strong positive correlation between nfGAT and fGAT among both glaucoma (r = 0.989, p < 0.001) and nonglaucoma (r = 0.955, p < 0.001). According to age, there is no significant difference in IOP value measured with nfGAT and fGAT for both glaucomas (p = 0.109) and nonglaucoma subjects (p = 0.076). However, significant differences were observed between nfGAT and fGAT mean IOP according to sex among both glaucomatous and nonglaucomatous subjects (p = 0.017 and p = 0.32, respectively). Conclusion The study suggests that the merits of intraocular pressure measured using GAT without fluorescein are not speculative, therefore the two techniques can be routinely used interchangeably in diagnosing and managing glaucoma.
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Affiliation(s)
| | - Thokozani Mzumara
- Department of OptometryMzuzu UniversityMzuzuMalawi
- Department of OphthalmologyMzimba North District HospitalMzuzuMalawi
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Hashemi H, Heydarian S, Aghamirsalim M, Yekta A, Hashemi A, Sajadi M, Khabazkhoob M. Distribution and associated factors of intraocular pressure in the older population: Tehran Geriatric Eye Study. Int J Ophthalmol 2023; 16:418-426. [PMID: 36935781 PMCID: PMC10009603 DOI: 10.18240/ijo.2023.03.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/03/2023] [Indexed: 03/06/2023] Open
Abstract
AIM To determine the distribution and associated factors of intraocular pressure (IOP) in an Iranian elderly population 60 years of age and above. METHODS The present report is part of the Tehran Geriatric Eye study (TGES), a population-based cross-sectional study that was conducted on the residents of Tehran 60 years of age and above. The sampling was performed using multistage stratified random cluster sampling methods from 22 districts of Tehran, Iran. Demographic and history information, blood samples, and blood pressure were collected from all participants. Ocular examinations included measurement of uncorrected and best-corrected visual acuity, objective and subjective refraction, and slit-lamp biomicroscopy. The IOP was measured using Goldmann applanation tonometry (GAT). Corneal imaging and ocular biometry were performed using Pentacam AXL. RESULTS The data of 3892 eyes of 2124 individuals were analyzed for this report. The mean age of the study participants was 66.49±5.31y (range: 60 to 95y). The mean IOP was 15.2 mm Hg (95%CI: 15.1 to 15.4), 15.3 mm Hg (95%CI: 15.1 to 15.5) and 15.1 mm Hg (95%CI: 15.0 to 15.3) in all participants, males, and females, respectively. Of the study participants, 1.3% had an IOP of ≥20 mm Hg. The mean IOP increased from 15.1 mm Hg in the age group 60-64y to 16.3 mm Hg in the age group ≥80y. According to the final multiple GEE model, the IOP was statistically significantly higher in men than in women. All the studied age groups, except for the 75-79-year-old age group, had significantly higher IOP compared to the 60-64-year-old age group. The IOP was significantly higher in underweight compared to other body mass index groups. Moreover, the IOP had a statistically significant direct relationship with the mean corneal power (mean CP), central corneal thickness (CCT), and systolic blood pressure. CONCLUSION The present study presents the distribution of IOP in an Iranian elderly population. A higher IOP (within the range 14 to 17 mm Hg) is significantly associated with older age, male sex, high systolic blood pressure, increased mean CP, and CCT. These factors should be considered in the clinical interpretation of IOP.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran 19839-63113, Iran
| | - Samira Heydarian
- Department of Rehabilitation Sciences, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari 1968653111, Iran
| | - Mohammadreza Aghamirsalim
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran 1157715354, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad 3453545, Iran
| | - Alireza Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran 1968653111, Iran
| | - Masoumeh Sajadi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran 1968653111, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran 1968653111, Iran
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